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.

Guthrie Medical Group, P.C. (NPI 1245246644)

Key Findings

Field	Value
Entity Type	Organization
Organization	Guthrie Medical Group, P.C.
Address	1 Guthrie Sq
City	Sayre
State	PA
ZIP	18840
Taxonomy	General Practice Physician
NPI Enumerated	July 31, 2006

Payer Source	Total Paid
Medicaid	$82.1M
Medicare	$0

This provider is effectively a single‑payer Medicaid operation: reported Medicaid revenue totals $82.1M and there is no Medicare billing on file. The lack of Medicare activity means the provider’s reimbursement exposure and patient panel are heavily concentrated in the Medicaid program rather than split across federal and state fee schedules.

Revenue is highly concentrated in outpatient evaluation-and-management visits: the precomputed top three Medicaid codes account for 70.6% of the provider’s total Medicaid revenue, driven by 99214 ($27.1M, 39.4%), 99213 ($19.5M, 28.3%), and U0003 ($2M, 2.9%). This concentration signals that routine office visits and episodic COVID PCR testing are the primary revenue drivers for the practice.

The code mix is consistent with a high-volume primary care/general practice operation: 99214 and 99213 together produce the largest shares of revenue and correspond to established patient visits with moderate-to-low levels of medical decision making and typical visit times of ~30 and ~20 minutes respectively. In addition, prominent preventive visit codes (99392, 99391, 99393, 99394) and vaccination codes (90471, 90472) indicate the practice delivers a significant volume of well visits and immunizations alongside chronic care.

This provider is a dominant statewide player for core office visit volume: 99214 ranks #1 of 8,157 providers in-state and 99213 ranks #1 of 8,867 providers in-state (both 100th percentile and labeled extreme outlier). Those #1 statewide ranks for the two highest-revenue E/M codes identify the organization as a major provider of Medicaid outpatient visits in Pennsylvania.

Preventive pediatric and vaccination services are systematically important to the operation. Codes such as 99392 ($1.9M, 2.8%, rank #3 of 819, 100th percentile, extreme outlier), 99391 ($1.7M, 2.4%, rank #2 of 664, 100th percentile, extreme outlier), 99393 ($1.5M, 2.2%, rank #3 of 870, 100th percentile, extreme outlier), 90471 (53.6K claims, $642.6K, rank #1 of 777, 100th percentile, extreme outlier) and 90472 (21.2K claims, $360.9K, rank #1 of 158, 100th percentile, extreme outlier) reflect outsized preventive care and immunization throughput relative to peers.

The provider also shows a substantial diagnostics and imaging footprint that complements ambulatory care: high‑revenue lab and imaging codes include 87637 ($1.7M, rank #2 of 83, 99th percentile, extreme outlier), 0202U ($1.2M, rank #8 of 55, 87th percentile), 88305 ($1.1M, rank #9 of 487, 98th percentile, extreme outlier), and 74177 ($1.1M, rank #10 of 484, 98th percentile). These rankings suggest either significant in‑house testing and pathology throughput or tightly integrated referral relationships for laboratory and imaging services.

While several COVID and respiratory testing codes appear at meaningful volumes, their statistical standing varies: U0003 ($2M, 2.9%) is ranked #14 of 197 in-state and labeled typical/unremarkable (93th percentile), whereas 87637 ($1.7M) is a 99th‑percentile extreme outlier. This mixed pattern indicates both routine participation in state testing programs and specific tests where the provider’s volume is unusually high.

The provider has long tenure in the NPI registry, enumerated 2006-07-31 (~20 years ago). That extended presence is consistent with the scale of its Medicaid volumes and the breadth of services billed, suggesting a mature practice with established patient panels and operational infrastructure across primary care, preventive services, and diagnostic testing.

Medicaid: Complete Services Breakdown

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

414 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	274,080	$100	$27.1M
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…	282,590	$70	$19.5M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	24,480	$80	$2M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	21,130	$90	$1.9M
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…	12,370	$150	$1.8M
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	11,860	$140	$1.7M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	20,010	$80	$1.7M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	16,400	$90	$1.5M
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…	13,470	$100	$1.3M
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	3,810	$330	$1.2M

Showing 1–10 of 414

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

Guthrie Medical Group, P.C. — 21 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

414 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	54	210	730	$40	$689.7K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	14	200	990	$70	$517.5K
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	8	60	430	$200	$354.2K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	489	540	1,490	$50	$316.4K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	47	180	860	$70	$195.9K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	32	50	70	$620	$190.6K
J0178	Injection, aflibercept, 1 mg	28	40	120	$340	$182.5K
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.	11	980	310	$50	$136.6K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	2	80	420	$100	$130.6K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	10	480	260	$90	$115.3K

Showing 1–10 of 414

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kaleida Health	NY	General Acute Care Hospital	$0	$80.7M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Inpatient Specialists Of California, PC	CA	Internal Medicine Physician	$0	$32.9M
Richard Park	CA	Internal Medicine Physician	$31.7M	$0
Kaleida Health	NY	General Acute Care Hospital	$0	$30.9M
Kaleida Health	NY	General Acute Care Hospital	$0	$22M
Ravindra Gautam	CA	Internal Medicine Physician	$13M	$0
Guthrie Medical Group PC	PA	Clinical Medical Laboratory	$2.1M	$2.9M
Jedediah Mcclintic	PA	Ophthalmology Physician	$3.2M	$18.9K
Michael Schekall	MN	Diagnostic Radiology Physician	$1.7M	$710

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Robert Packer Hospital	PA	General Acute Care Hospital	$0	$13.8M
Greater Valley Emergency Medical Services Inc.	PA	Land Ambulance	$512.8K	$1.5M
Didier Alipui	PA	Surgery Physician	$901.5K	$161.9K
Shing Chin	PA	Radiation Oncology Physician	$935.2K	$0
Godfred Eyiah-mensah	PA	General Practice Physician	$355.9K	$138.3K
Pramod Deshmukh	PA	Cardiovascular Disease Physician	$391K	$7.9K
Ferrol Lee	PA	Endocrinology, Diabetes & Metabolism Physician	$138.3K	$154.6K
Mason Stilwell	PA	Adult Reconstructive Orthopaedic Surgery Physician	$242.5K	$580
Steven Rinehouse	PA	Diagnostic Radiology Physician	$180.9K	$26.1K
Sudhakar Sattur	PA	Interventional Cardiology Physician	$178.8K	$19.3K

Guthrie Medical Group, P.C. — Billing Profile & Reimbursement Data

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Guthrie Medical Group, P.C. — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References