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.

Upmc Hamot (NPI 1487647590)

Field	Value
Entity Type	Organization
Organization	Upmc Hamot
Address	201 State St
City	Erie
State	PA
ZIP	16550
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 24, 2005

Payer Source	Total Paid
Medicaid	$18.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

334 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	45,970	$120	$5.3M
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.	27,510	$80	$2.2M
G0378	Hospital observation service, per hour	5,490	$310	$1.7M
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.	10,270	$140	$1.4M
0241U	N/A	5,150	$90	$437.8K
T1015	Clinic visit/encounter, all-inclusive	14,400	$30	$417.5K
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	3,430	$110	$383.9K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	43,890	$10	$351.1K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	15,470	$20	$340.3K
J9271	Injection, pembrolizumab, 1 mg	400	$740	$291.1K

Showing 1–10 of 334

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

Upmc Hamot — 12 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

334 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	10	150	510	$870	$1.4M
T1015	Clinic visit/encounter, all-inclusive	182	1,690	760	$170	$1.2M
J9271	Injection, pembrolizumab, 1 mg	13	20	420	$1,230	$827.7K
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.	84	210	730	$40	$689.7K
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	42	130	1,190	$100	$528.9K
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…	78	200	990	$70	$517.5K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	96	410	1,130	$60	$455.4K
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.	24	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.	25	1,060	150	$130	$405.4K
A4351	Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each	20	20	590	$100	$332.8K

Showing 1–10 of 334

Nearby Providers

Other providers in the same ZIP code as Upmc Hamot, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Richard Kocan	PA	Diagnostic Radiology Physician	$104.3K	$169.8K
Rachel Lagos	PA	Diagnostic Radiology Physician	$246.1K	$3.4K
Antonio Pena	PA	Diagnostic Radiology Physician	$133.5K	$114.3K
Jennifer Naber	PA	Anatomic Pathology & Clinical Pathology Physician	$82.9K	$146.9K
Stephen Oljeski	PA	Diagnostic Radiology Physician	$156.1K	$40.4K
Dale Stevens	PA	Diagnostic Radiology Physician	$73.3K	$75.6K
Angelo Zerbonia	PA	Diagnostic Radiology Physician	$59.7K	$83.9K
Samuel Zerkle	PA	Undersea and Hyperbaric Medicine (Emergency Medicine) Physician	$72.7K	$0
Kim Krichko	PA	Certified Registered Nurse Anesthetist	$46K	$0
Mark Yost	PA	Diagnostic Radiology Physician	$27.3K	$10.1K

Upmc Hamot — Billing Profile & Reimbursement Data

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Upmc Hamot — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References