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.

The Milton S Hershey Medical Center (NPI 1568435477)

Field	Value
Entity Type	Organization
Organization	The Milton S Hershey Medical Center
Address	500 University Dr
City	Hershey
State	PA
ZIP	17033
Taxonomy	General Acute Care Hospital
NPI Enumerated	February 10, 2006

Payer Source	Total Paid
Medicaid	$78.9M
Medicare	$0

Key Findings

This provider is effectively single-payer in the available claims data: there is no Medicare billing on file and lifetime Medicaid revenue is $78.9M, so all observed government payer activity in this dataset is concentrated in Medicaid. Analysts should treat Medicare comparisons as not applicable for this entity because no Medicare CPT/HCPCS activity is reported here.

Revenue is highly concentrated in a small set of outpatient and emergency codes: the top 3 Medicaid codes (G0463, 99284, 99283) account for 56.9% of this provider's total Medicaid revenue, with G0463 alone representing 27.0% of Medicaid revenue. That concentration indicates the provider’s Medicaid receipts are driven primarily by hospital outpatient clinic encounters and emergency department services rather than a broad mix of inpatient DRG or tertiary specialty line items.

The code mix points to a hospital that operates a very large outpatient clinic and a high-throughput emergency department. G0463 (hospital outpatient clinic visit) is the single largest revenue driver, and the presence of 99284, 99283, and 99285 (ED E/M codes at low, moderate, and high decision-making levels) plus G0378 (observation per hour) shows a care model that funnels substantial patient volume through ED and short-stay observation workflows.

G0463 shows extreme statewide dominance: it ranks #1 of 100 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code). That ranking, together with G0463’s $14.7M revenue and 305.8K claims, signals this provider is a primary outpatient clinic billing center in Pennsylvania’s Medicaid market for that service.

Emergency department activity is unusually large relative to peers: 99284 ($9.2M revenue) ranks #47 of 1604 providers in-state (97th percentile; notably above typical state volume) and 99283 ($7.1M) ranks #23 of 1063 (98th percentile; notably above typical state volume). 99285 is present too but at a more typical percentile (#83 of 1228, 93th percentile), which suggests particularly heavy volumes at the low-to-moderate ED complexity levels rather than being concentrated only in the highest-complexity ED visits.

The provider also posts extreme/very high volume in low-complexity outpatient encounters: 99211 shows 72.8K claims and $2.2M revenue and ranks #2 of 978 providers in-state (100th percentile; extreme outlier). This pattern reinforces a large ambulatory nursing/clinic throughput component (brief, low-RVU visits) that complements its ED and outpatient clinic footprint.

Specialty and ancillary service lines are meaningful but secondary to outpatient/ED work: high-ranking codes include infusion and oncology-related items (J9271, J1745, 96413), diagnostic testing (U0003, 87633), sleep studies (95810, 95782), and imaging (93304, 70553). Notably, J1459 (IVIG) ranks #1 of 3 providers in-state (100th percentile) which indicates the provider is the primary Medicaid biller for that specific, relatively rare service in the small universe of state providers offering it.

The provider has an established operational history in NPI records—NPI enumerated (registered) 2006-02-10 (~20 years ago)—and the combination of long tenure, $78.9M Medicaid revenue, and multiple extreme or notably-above-typical percentile rankings suggests a well-established regional presence in Pennsylvania’s Medicaid acute and ambulatory care market rather than a small or new entrant.

Medicaid: Complete Services Breakdown

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

740 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	305,790	$50	$14.7M
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.	25,510	$360	$9.2M
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.	28,230	$250	$7.1M
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.	8,550	$540	$4.6M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	72,810	$30	$2.2M
G0378	Hospital observation service, per hour	2,150	$800	$1.7M
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	170	$7,460	$1.3M
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	1,280	$870	$1.1M
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…	12,370	$90	$1.1M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	7,170	$130	$946K

Showing 1–10 of 740

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

The Milton S Hershey Medical Center — 6 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

740 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A0431	Ambulance service, conventional air services, transport, one way (rotary wing)	7	10	280	$2,940	$5.9M
A0434	Specialty care transport (sct)	10	10	350	$20	$2M
J2350	Injection, ocrelizumab, 1 mg	6	10	170	$6,410	$1.9M
J2357	Injection, omalizumab, 5 mg	2	10	320	$1,550	$1.6M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	2	20	350	$1,720	$1.6M
G0378	Hospital observation service, per hour	33	150	510	$870	$1.4M
J2323	Injection, natalizumab, 1 mg	4	10	240	$2,130	$1.2M
T1015	Clinic visit/encounter, all-inclusive	253	1,690	760	$170	$1.2M
A0436	Rotary wing air mileage, per statute mile	7	10	240	$690	$1.2M
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…	503	690	2,240	$80	$1M

Showing 1–10 of 740

Related Providers

Other providers that share a Tax Identification Number (TIN) with The Milton S Hershey Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Claire Flaherty	PA	Neurology Physician	$21.9K	$0
Elana Farace	PA	Clinical Neuropsychologist	$18.9K	$0
Venkata Jakkampudi	PA	Clinical Neurophysiology Physician	$18.4K	$420
Paul Eslinger	PA	Clinical Psychologist	$18.1K	$0
Sharon Hattrick	PA	Clinical Psychologist	$14.8K	$0
Christa Vanbelkum	PA	Clinical Psychologist	$6.7K	$0

Nearby Providers

Other providers in the same ZIP code as The Milton S Hershey Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Milton S. Hershey Medical Center Physicians Group	PA	Sports Medicine (Neuromusculoskeletal Medicine) Physician	$0	$26.6M
The Vista Foundation	PA	Public Health or Welfare Agency	$0	$19.4M
Prelude Corporation	PA	Clinical Medical Laboratory	$4.9M	$0
Hershey Outpatient Surgery Center LLC	PA	Ambulatory Surgical Clinic/Center	$802.7K	$186.3K
Ghulam Mustafa	PA	Nuclear Medicine Physician	$628.8K	$140
Rebecca Roller	PA	Internal Medicine Physician	$608.8K	$0
Ivan Zucker	PA	Nuclear Medicine Physician	$359.6K	$0
Kristen Foering	PA	Dermatology Physician	$298.5K	$0
Shane Lince	PA	Surgery Physician	$266.4K	$1.1K
Hersheycare Inc	PA	Long Term Care Pharmacy	$202.5K	$0

The Milton S Hershey Medical Center — Billing Profile & Reimbursement Data

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The Milton S Hershey Medical Center — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References