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.

Butler Healthcare Providers (NPI 1447317896)

Field	Value
Entity Type	Organization
Organization	Butler Healthcare Providers
Address	1 Hospital Way
City	Butler
State	PA
ZIP	16001
Taxonomy	General Acute Care Hospital
NPI Enumerated	January 3, 2007

Payer Source	Total Paid
Medicaid	$10.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

235 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0039	Assertive community treatment, face-to-face, per 15 minutes	13,030	$280	$3.6M
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.	26,010	$130	$3.4M
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…	6,260	$80	$494.1K
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.	2,910	$140	$402.1K
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.	2,810	$100	$289.5K
T1015	Clinic visit/encounter, all-inclusive	10,330	$30	$258.2K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	23,460	$10	$187.7K
G0378	Hospital observation service, per hour	370	$380	$140.2K
U0005	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, cdc or non-cdc,…	6,000	$20	$113.9K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	5,180	$20	$98.4K

Showing 1–10 of 235

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

Butler Healthcare Providers — 4 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

235 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0039	Assertive community treatment, face-to-face, per 15 minutes	31	40	27,890	$150	$6.2M
G0378	Hospital observation service, per hour	90	150	510	$870	$1.4M
T1015	Clinic visit/encounter, all-inclusive	217	1,690	760	$170	$1.2M
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	90	130	310	$60	$769.3K
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.	96	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…	37	200	990	$70	$517.5K
A6021	Collagen dressing, sterile, size 16 sq. in. or less, each	5	10	2,580	$120	$490.3K
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.	43	1,600	270	$120	$409.7K
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.	201	1,060	150	$130	$405.4K
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.	148	1,230	250	$130	$284K

Showing 1–10 of 235

Related Providers

Other providers that share a Tax Identification Number (TIN) with Butler Healthcare Providers, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
S. Kreps	PA	Child & Adolescent Psychiatry Physician	$39.8K	$462.6K

Nearby Providers

Other providers in the same ZIP code as Butler Healthcare Providers, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vocational Services	PA	Psychologist	$0	$22.4M
Center For Community Resources, Inc.	PA	Case Management Agency	$0	$19M
Family Pathways	PA	Community/Behavioral Health Agency	$0	$6.7M
Butler Ambulance Service Co	PA	Ambulance	$446.9K	$2.2M
Jeanine Wigton	PA	Family Nurse Practitioner	$40.1K	$1.1M
Butler Ambulatory Surgery Center L L C	PA	Ambulatory Surgical Clinic/Center	$680.6K	$24.7K
David Cowan	PA	Dermatology Physician	$175.8K	$31.6K
Keith Welker	PA	Specialist	$147.5K	$48.1K
Shripal Shrishrimal	PA	Pulmonary Disease Physician	$80.1K	$40.1K
Dennis Dobrzynski	PA	Hematology & Oncology Physician	$92.1K	$26.6K

Butler Healthcare Providers — Billing Profile & Reimbursement Data

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Butler Healthcare Providers — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References