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.

Miguel Pinilla Vera (NPI 1285976373)

Field	Value
Entity Type	Individual
Organization	Miguel Pinilla Vera
Address	200 Lothrop St
City	Pittsburgh
State	PA
ZIP	15213
Taxonomy	Advanced Heart Failure and Transplant Cardiology Physician
NPI Enumerated	March 27, 2013

Payer Source	Total Paid
Medicare	$93.7K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	400	$110	$42K
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…	210	$120	$25.4K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	60	$190	$11.5K
93750	In this procedure, the provider tests the settings of a ventricular assist device, a mechanical pump connected to the heart and aorta that ensures adequate blood flow in the presence of heart…	220	$40	$7.9K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	50	$150	$7.1K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Pennsylvania Distribution

Miguel Pinilla Vera — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99233	421	6,630	70	$90	$12K
99291	1,350	3,800	40	$170	$11.7K
99215	523	7,170	40	$120	$8.6K
99223	2,872	7,020	40	$130	$7.8K
93750	3	30	50	$30	$2.4K

Nearby Providers

Other providers in the same ZIP code as Miguel Pinilla Vera, 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

Miguel Pinilla Vera — Billing Profile & Reimbursement Data

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Miguel Pinilla Vera — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References