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 Physician Group, LLP (NPI 1609008176)

Field	Value
Entity Type	Organization
Organization	Pinnacle Physician Group, LLP
Address	657 Helen Keller Blvd
City	Tuscaloosa
State	AL
ZIP	35404
Taxonomy	Hospitalist Physician
NPI Enumerated	August 18, 2009

Payer Source	Total Paid
Medicaid	$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.

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	39,000	$10	$390K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	17,820	$20	$285.2K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	5,280	$40	$184.7K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	3,700	$20	$81.3K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	1,500	$20	$33K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	880	$20	$15K
99219	N/A	350	$30	$9.8K
99220	N/A	140	$40	$5.8K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	470	$10	$3.3K
99217	N/A	90	$20	$2K

Showing 1–10 of 12

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 Physician Group, LLP — 5 of 11 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

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	9	250	420	$50	$133K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	6	400	470	$30	$97.1K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	42	200	170	$50	$60.5K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	3	240	130	$80	$46.1K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	5	130	110	$70	$36.9K
99219	N/A	2	10	270	$80	$35K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	13	160	80	$80	$31.6K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	46	140	160	$20	$15.8K
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	6	30	40	$10	$3.9K
99220	N/A	1	10	50	$60	$3.4K

Showing 1–10 of 12

Related Providers

Other providers that share a Tax Identification Number (TIN) with Pinnacle Physician Group, LLP, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Charles Abney	AL	Family Medicine Physician	$322.6K	$0
Gary Thomas	AL	Internal Medicine Physician	$313.4K	$0
Abdu Mohamed Abdallah Ahmed	MS	Family Medicine Physician	$186K	$0
Martin Hajjar	AL	Emergency Medical Services (Emergency Medicine) Physician	$156.1K	$0
Jennifer Burdette	AL	Family Medicine Physician	$103.6K	$0
Margaret Morr	AL	Family Medicine Physician	$30.5K	$0

Nearby Providers

Other providers in the same ZIP code as Pinnacle Physician Group, LLP, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tuscaloosa Pediatric Dentistry, P.C.	AL	Pediatric Dentistry	$0	$5.7M
New Hope LLC	AL	Occupational Therapist	$0	$4.2M
Univiversity Oral And Facial Surgery, P.C.	AL	Oral and Maxillofacial Surgery (Dentist)	$0	$1.7M
Crimson Urgent Care, LLC	AL	Family Medicine Physician	$0	$1.5M
Hospice Of West Alabama, Inc.	AL	Community Based Hospice Care Agency	$0	$1.4M
Timothy Johnson	AL	Specialist	$411.8K	$0
John Warren	AL	Internal Medicine Physician	$356.4K	$0
Ross Vaughn	AL	Internal Medicine Physician	$344.2K	$0
Scott Fulgham	AL	Internal Medicine Physician	$280.5K	$0
John Miller	AL	Internal Medicine Physician	$267.9K	$0

Pinnacle Physician Group, LLP — Billing Profile & Reimbursement Data

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Pinnacle Physician Group, LLP — 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