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 Kentucky for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Kentucky 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. Kentucky (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.

Pineville Community Health Center Inc (NPI 1285292219)

Pineville Community Health Center Inc is a general acute care hospital provider located in Pineville, Kentucky. This profile covers 0 Medicare and 99 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	Pineville Community Health Center Inc
Address	850 Riverview Ave
City	Pineville
State	KY
ZIP	40977
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 4, 2019

Payer Source	Total Paid
Medicaid	$3.7M
Medicare	$0

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

99 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	7,750	$120	$899.5K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	4,200	$150	$637.6K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	2,770	$130	$354.6K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	1,400	$150	$215.4K
G0378	Hospital observation service, per hour	540	$280	$150.1K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	740	$160	$115.1K
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…	3,840	$30	$111.2K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	1,310	$80	$108.9K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	5,400	$20	$97.1K
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	3,870	$30	$96.7K

Showing 1–10 of 99

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Pineville Community Health Center Inc — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

99 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	157	280	7,150	$150	$3M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	139	240	4,710	$150	$2.6M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	126	280	5,700	$120	$2M
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.	167	180	1,870	$280	$1.5M
G0378	Hospital observation service, per hour	71	90	2,770	$190	$1.3M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	122	170	2,610	$250	$1M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	85	110	8,390	$50	$749.1K
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.	201	340	2,700	$40	$673.3K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	140	180	2,960	$110	$672.4K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	82	100	5,870	$70	$670.3K

Showing 1–10 of 99

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pineville Community Health Center Inc	KY	Rural Health Clinic/Center	$0	$7.5M
Christopher Steidle	KY	Urology Physician	$114K	$0
Grace Runions	KY	Psychiatric/Mental Health Nurse Practitioner	$25.5K	$220
Martha Combs-woolum	KY	Internal Medicine Physician	$15.8K	$0
Madhan Mohan	KY	Internal Medicine Physician	$12.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Log Mountain Family Healthcare LLC	KY	Family Nurse Practitioner	$0	$4M
County Of Bell	KY	Land Ambulance	$172.6K	$482.2K
Corey Campbell	KY	Physician Assistant	$170.9K	$0
Chasity King	KY	Family Nurse Practitioner	$15.8K	$0

Pineville Community Health Center Inc — Billing Profile & Reimbursement Data

Sign up for Pineville Community Health Center Inc — Billing Profile & Reimbursement Data policy alerts

Pineville Community Health Center Inc — Billing Profile & Reimbursement Data

Sign up for Pineville Community Health Center Inc — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References