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

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

Pinnacle Enterprises PC (NPI 1447374640)

Pinnacle Enterprises PC is a general practice physician provider located in Phenix City, Alabama. This profile covers 0 Medicare and 83 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	Pinnacle Enterprises PC
Address	3700 S Railroad St Ste A
City	Phenix City
State	AL
ZIP	36867
Taxonomy	General Practice Physician
NPI Enumerated	March 16, 2007

Payer Source	Total Paid
Medicaid	$5.1M
Medicare	$0

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

83 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…	19,200	$80	$1.6M
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…	18,750	$60	$1.2M
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…	4,140	$70	$277.1K
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…	3,620	$70	$242.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,560	$70	$231.5K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	5,460	$40	$207.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,130	$70	$138.3K
90834	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…	3,500	$40	$129.5K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	11,340	$10	$113.4K
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…	870	$120	$100.2K

Showing 1–10 of 83

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alabama Distribution

Pinnacle Enterprises PC — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

83 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	96	180	100	$120	$381.8K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	246	380	440	$90	$362K
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…	33	120	500	$50	$317.7K
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…	67	1,990	680	$60	$201.7K
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…	59	330	140	$240	$197.4K
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…	123	1,990	560	$40	$185.6K
90834	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…	12	110	240	$60	$175.6K
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…	66	270	1,360	$60	$159.7K
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…	61	300	1,160	$50	$147.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	47	320	640	$50	$98.1K

Showing 1–10 of 83

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bill Berryman	AL	Pain Medicine Physician	$147.9K	$0
Bradley Carden	AL	Family Medicine Physician	$60.5K	$0
Jonathan Gallinger	GA	Medical Physician Assistant	$32.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Christa D. Spann Dmd, LLC	AL	General Practice Dentistry	$0	$3.2M
Caring For Kids	AL	Pediatrics Physician	$0	$3M
Jacksons Point Of Light Family Medicine Inc.	AL	Family Medicine Physician	$0	$2.2M
R. Griff Gordy PC	AL	Optometrist	$0	$1.2M
Columbus Hospice Of Alabama	AL	Community Based Hospice Care Agency	$0	$1.2M
Phenix Speech And Language Services	AL	Speech-Language Pathologist	$0	$1.1M
Eye Lab Vision Center, Inc.	AL	Optometrist	$0	$938.8K
Russell County Community Hospital LLC	AL	General Acute Care Hospital	$0	$869.5K
Russell County Health Dept Fp Clinic	AL	Public Health or Welfare Agency	$0	$858.4K
Dennis Harden	AL	Family Medicine Physician	$355.7K	$0

Pinnacle Enterprises PC — Billing Profile & Reimbursement Data

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Pinnacle Enterprises PC — 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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