Loading...
NPI 1164494803 · Pittsburgh, PA · Specialist
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
John Caldwell is a specialist provider located in Pittsburgh, Pennsylvania. This profile covers 6 Medicare and 2 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | John Caldwell |
| Address | 200 Lothrop St |
| City | Pittsburgh |
| State | PA |
| ZIP | 15213 |
| Taxonomy | Specialist |
| NPI Enumerated | February 6, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $53.9K |
| Medicare | $26.5K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 00731 | The anesthesia provider performs anesthesia services for an unspecified type of upper gastrointestinal endoscopic procedure during which another provider introduces the endoscope to but not beyond… | 210 | $70 | $13.5K |
| 00811 | The provider performs anesthesia services for a patient undergoing an unspecified lower intestinal endoscopic procedure where the surgical provider introduces an endoscope into the intestines up to… | 80 | $60 | $5.1K |
| 00732 | The anesthesia provider performs anesthesia services for an endoscopic retrograde cholangiopancreatography (ERCP) during which another provider introduces the endoscope to the proximal (upper) part… | 50 | $80 | $4.3K |
| 00813 | The anesthesia provider performs anesthesia services for a patient undergoing both upper and lower intestinal endoscopy where the surgical provider introduces an endoscope into the intestines above… | 30 | $70 | $2K |
| 00812 | The provider performs anesthesia services for a patient undergoing a screening colonoscopy during which the surgical provider introduces an endoscope into the intestines below the duodenum, the part… | 20 | $60 | $1.1K |
| 36620 | In this procedure, the provider inserts a catheter percutaneously (through the skin) into an artery and uses this catheter for the purpose of sampling, transfusion, or continuous real–time blood… | 20 | $40 | $530 |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 00731 | The anesthesia provider performs anesthesia services for an unspecified type of upper gastrointestinal endoscopic procedure during which another provider introduces the endoscope to but not beyond… | 540 | $100 | $52.3K |
| 00811 | The provider performs anesthesia services for a patient undergoing an unspecified lower intestinal endoscopic procedure where the surgical provider introduces an endoscope into the intestines up to… | 10 | $120 | $1.6K |
How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Pennsylvania median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 00731 | The anesthesia provider performs anesthesia services for an unspecified type of upper gastrointestinal endoscopic procedure during which another provider introduces the endoscope to but not beyond… | 10 | 90 | 60 | $70 | $16.3K |
| 00811 | The provider performs anesthesia services for a patient undergoing an unspecified lower intestinal endoscopic procedure where the surgical provider introduces an endoscope into the intestines up to… | 32 | 40 | 40 | $60 | $13.3K |
Other providers in the same ZIP code as John Caldwell, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Upmc Presbyterian Shadyside | PA | General Acute Care Hospital | $0 | $125.5M |
| Upmc Magee-womens Hospital | PA | General Acute Care Hospital | $0 | $43M |
| University Of Pittsburgh Physicians | PA | Psychiatry Physician | $0 | $26.4M |
| University Of Pittsburgh Physicians | PA | Specialist | $0 | $23.6M |
| Upmc Presbyterian Shadyside | PA | Methadone Clinic | $165.7K | $5.9M |
| Shyam Kodati | PA | Ophthalmology Physician | $1.1M | $0 |
| Sandeep Sharma | PA | Nephrology Physician | $900.7K | $0 |
| Badreddine Bencherif | PA | Specialist | $560.6K | $0 |
| Ashima Lall | PA | Diagnostic Radiology Physician | $518.1K | $41.5K |
| Andrew Eller | PA | Specialist | $509.8K | $290 |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.