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.

Pinnacle Health Emergency Department Services LLC (NPI 1487693404)

Field	Value
Entity Type	Organization
Organization	Pinnacle Health Emergency Department Services LLC
Address	111 S Front St
City	Harrisburg
State	PA
ZIP	17101
Taxonomy	Emergency Medicine Physician
NPI Enumerated	June 5, 2006

Payer Source	Total Paid
Medicaid	$14.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

5 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.	110,110	$80	$8.8M
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.	43,150	$90	$3.9M
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.	22,940	$50	$1.2M
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.	5,480	$40	$213.8K
99281	The provider sees a patient for the lowest level emergency department visit.	1,000	$30	$24.9K

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

Pinnacle Health Emergency Department Services LLC — 3 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. Pennsylvania median

5 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.	5	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.	36	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.	14	1,230	250	$130	$284K
99281	The provider sees a patient for the lowest level emergency department visit.	16	120	190	$130	$90.3K
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.	22	340	250	$80	$89K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Pinnacle Health Emergency Department Services LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Howard Fugate	PA	Internal Medicine Physician	$205K	$28.5K
Yolanda Michetti	PA	Emergency Medicine Physician	$33.2K	$0
Megan O'donovan	PA	Physician Assistant	$19.6K	$0

Nearby Providers

Other providers in the same ZIP code as Pinnacle Health Emergency Department Services LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Upmc Pinnacle Hospitals	PA	General Acute Care Hospital	$0	$26.9M
Allison Ann Lyavdansky	PA	Gerontology Nurse Practitioner	$743.8K	$12.8K
Emily Smerilli	PA	Family Nurse Practitioner	$203.6K	$11K
Tracey Shivok-jefferson	PA	Family Nurse Practitioner	$131.1K	$1.7K
Sandra Stom	PA	Family Nurse Practitioner	$118.8K	$820
Karen Bensinger	PA	Nurse Practitioner	$108K	$480
Joshua Ruopp	PA	Certified Registered Nurse Anesthetist	$61K	$0
Tyshaun James-hart	PA	Surgery Physician	$44K	$3.1K
Joshua Stadler	PA	Internal Medicine Physician	$41.8K	$0
Dilshad Khan	PA	Internal Medicine Physician	$39.2K	$0

Pinnacle Health Emergency Department Services LLC — Billing Profile & Reimbursement Data

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Pinnacle Health Emergency Department Services LLC — 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