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.

Lehigh Valley Hospital Pocono (NPI 1568459436)

Field	Value
Entity Type	Organization
Organization	Lehigh Valley Hospital Pocono
Address	206 E Brown St
City	East Stroudsburg
State	PA
ZIP	18301
Taxonomy	General Acute Care Hospital
NPI Enumerated	October 5, 2005

Payer Source	Total Paid
Medicaid	$11.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

256 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.	23,620	$170	$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.	17,780	$120	$2.1M
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.	6,690	$170	$1.1M
G0378	Hospital observation service, per hour	540	$700	$378.7K
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.	28,320	$10	$283.2K
X0621	N/A	1,270	$210	$272.4K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	13,410	$10	$187.8K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	2,330	$80	$179K
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…	1,960	$80	$162.8K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	1,140	$140	$162.3K

Showing 1–10 of 256

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

Lehigh Valley Hospital Pocono — 3 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

256 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	71	150	510	$870	$1.4M
T1015	Clinic visit/encounter, all-inclusive	677	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…	40	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.	88	210	730	$40	$689.7K
J0517	Injection, benralizumab, 1 mg	2	10	130	$4,470	$590.2K
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…	65	200	990	$70	$517.5K
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.	52	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.	48	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.	96	1,230	250	$130	$284K
81220	The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR…	14	10	470	$260	$227K

Showing 1–10 of 256

Related Providers

Other providers that share a Tax Identification Number (TIN) with Lehigh Valley Hospital Pocono, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lehigh Valley Hospital	PA	General Acute Care Hospital	$0	$64.3M
Lehigh Valley Physician Group	PA	Family Medicine Physician	$0	$21.9M
Lehigh Valley Physician Group	PA	Emergency Medicine Physician	$0	$16.3M
Family Care Centers Inc.	PA	Internal Medicine Physician	$0	$11.1M
Hazleton Professional Services	PA	Internal Medicine Physician	$0	$8.3M
Lehigh Valley Physician Group	PA	Pediatrics Physician	$0	$7.6M
Family Care Centers Inc	PA	Family Medicine Physician	$0	$6.1M
Lehigh Valley Physician Group	PA	Pediatric Emergency Medicine (Emergency Medicine) Physician	$0	$5.9M
Eugene Grady	PA	Rheumatology Physician	$1.7M	$980
Joseph Zaladonis	PA	Specialist	$1.4M	$0

Nearby Providers

Other providers in the same ZIP code as Lehigh Valley Hospital Pocono, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Matrix Behavior Solutions, LLC	PA	Behavior Analyst	$0	$75.6M
Loving Care Agency, Inc.	PA	Home Health Agency	$0	$27.4M
Gerald Negvesky	PA	Ophthalmology Physician	$446.1K	$0
Laszlo Szollas	PA	Interventional Pain Medicine Physician	$417.3K	$0
Gordon Fried	PA	Interventional Cardiology Physician	$305.5K	$130
Roger Componovo	PA	Adult Reconstructive Orthopaedic Surgery Physician	$299.8K	$0
Javed Malik	PA	Diagnostic Radiology Physician	$205.4K	$65.7K
Alan Westheim	PA	Dermatology Physician	$250.1K	$0
Samer Alkhuja	PA	Pulmonary Disease Physician	$243.9K	$2.7K
Mae Cheryl Laborde	PA	Adult Health Nurse Practitioner	$213K	$15.4K

Lehigh Valley Hospital Pocono — Billing Profile & Reimbursement Data

Sign up for Lehigh Valley Hospital Pocono — Billing Profile & Reimbursement Data policy alerts

Lehigh Valley Hospital Pocono — Billing Profile & Reimbursement Data

Sign up for Lehigh Valley Hospital Pocono — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References