Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Pennsylvania for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Pennsylvania only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Pennsylvania (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Geisinger Clinic (NPI 1164716643)

Geisinger Clinic is a family medicine physician provider located in Danville, Pennsylvania. This profile covers 0 Medicare and 37 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Geisinger Clinic
Address	175 Northumberland Street
City	Danville
State	PA
ZIP	17821
Taxonomy	Family Medicine Physician
NPI Enumerated	June 2, 2011

Payer Source	Total Paid
Medicaid	$13.4M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

37 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	239,300	$30	$8.1M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	44,310	$50	$2.3M
S9088	Services provided in an urgent care center (list in addition to code for service)	59,220	$20	$1.1M
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	13,030	$50	$703.4K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	15,610	$20	$312.1K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	10,270	$30	$256.8K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	30,380	$10	$212.7K
0241U	N/A	1,010	$80	$81.7K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	1,990	$30	$67.6K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	850	$70	$60.5K

Showing 1–10 of 37

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.

Claims Volume vs. Pennsylvania Distribution

Geisinger Clinic — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

37 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	42	980	310	$50	$136.6K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	174	190	2,160	$30	$95.7K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	15	8,160	210	$60	$68.4K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	2	8,870	240	$40	$56.1K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	188	220	2,320	$10	$51.2K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	434	450	1,220	$1	$48K
0241U	N/A	45	190	180	$60	$46.5K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	138	1,210	100	$90	$45K
S9088	Services provided in an urgent care center (list in addition to code for service)	1	500	520	$30	$42.1K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	398	1,410	60	$90	$30.5K

Showing 1–10 of 37

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Geisinger Clinic	PA	Surgery Physician	$0	$74.6M
Jefferson University Physicians	PA	General Practice Physician	$0	$30.8M
Geisinger Pharmacy LLC	PA	Pharmacy	$0	$26.7M
The Milton S. Hershey Medical Center Physicians Group	PA	Sports Medicine (Neuromusculoskeletal Medicine) Physician	$0	$26.6M
Geisinger Clinic - Outpatient Psych	PA	Counselor	$0	$19.6M
Geisinger Clinic	PA	Diagnostic Radiology Physician	$0	$14.9M
Geisinger Bloomsburg Hospital	PA	General Acute Care Hospital	$0	$7.2M
Geisinger Wyoming Valley Medical Center	PA	General Acute Care Hospital	$0	$7M
Geisinger Clinic	PA	Addiction (Substance Use Disorder) Psychologist	$0	$5.8M
Ravi Pandit	OK	Retina Specialist (Ophthalmology) Physician	$2.5M	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cmsu Behavioral Health And Developmental Services	PA	Community/Behavioral Health Agency	$0	$21.8M
15 Wesner Lane Pecc Operating Company, LP	PA	Medically Fragile Infants and Children Day Care	$0	$6.5M
West Shore Advanced Life Support Services, Inc.	PA	Paramedic	$1.6M	$4.4M
Cassondra Ellison	PA	Dermatology Physician	$100.4K	$0
Wells Reinheimer	PA	Ophthalmology Physician	$96.4K	$0
Louis Grandizio	PA	Orthopaedic Surgery Physician	$49.6K	$0

Geisinger Clinic — Billing Profile & Reimbursement Data

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Geisinger Clinic — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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