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.

Geisinger Clinic (NPI 1639600075)

Field	Value
Entity Type	Organization
Organization	Geisinger Clinic
Address	3 W Olive St
City	Scranton
State	PA
ZIP	18508
Taxonomy	Addiction (Substance Use Disorder) Psychologist
NPI Enumerated	March 27, 2017

Payer Source	Total Paid
Medicaid	$5.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G9012	Other specified case management service not elsewhere classified	25,340	$100	$2.6M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	36,920	$50	$1.8M
T2023	Targeted case management; per month	14,450	$40	$578.1K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	20,130	$20	$483.2K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	9,130	$20	$191.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	1,020	$40	$39.8K
Q3014	Telehealth originating site facility fee	600	$30	$17.9K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	1,800	$10	$10.8K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	170	$40	$7.2K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	440	$20	$7.1K

Showing 1–10 of 20

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

Geisinger Clinic — 5 of 19 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

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2315	Injection, naltrexone, depot form, 1 mg	4	10	3,300	$950	$8M
G9012	Other specified case management service not elsewhere classified	5	320	770	$260	$758K
T2023	Targeted case management; per month	1	10	890	$70	$282.2K
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.	768	980	310	$50	$136.6K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	21	8,160	210	$60	$68.4K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	97	8,870	240	$40	$56.1K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	88	260	40	$200	$49.4K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	114	1,210	100	$90	$45K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	415	1,410	60	$90	$30.5K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	853	1,630	90	$30	$22K

Showing 1–10 of 20

Related Providers

Other providers that share a Tax Identification Number (TIN) with Geisinger Clinic, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Geisinger Clinic	PA	Surgery Physician	$0	$74.6M
Jefferson University Physicians	PA	General Practice Physician	$0	$30.8M
Geisinger Pharmacy LLC	PA	Pharmacy	$0	$26.7M
The Milton S. Hershey Medical Center Physicians Group	PA	Sports Medicine (Neuromusculoskeletal Medicine) Physician	$0	$26.6M
Geisinger Clinic - Outpatient Psych	PA	Counselor	$0	$19.6M
Geisinger Clinic	PA	Diagnostic Radiology Physician	$0	$14.9M
Geisinger Clinic	PA	Family Medicine Physician	$0	$13.4M
Geisinger Bloomsburg Hospital	PA	General Acute Care Hospital	$0	$7.2M
Geisinger Wyoming Valley Medical Center	PA	General Acute Care Hospital	$0	$7M
Ravi Pandit	OK	Retina Specialist (Ophthalmology) Physician	$2.5M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Crystal Vision Center, Inc.	PA	Eyewear Supplier	$0	$5.7M
Paul Horchos	PA	Physical Medicine & Rehabilitation Physician	$205K	$91.2K
Sheryl Oleski	PA	Interventional Pain Medicine Physician	$219.9K	$62.3K
Elizabeth Karazim-horchos	PA	Physical Medicine & Rehabilitation Physician	$126.6K	$102.6K
John Doherty	PA	Orthopaedic Surgery Physician	$207.1K	$0
Tracey Galardi	PA	Internal Medicine Physician	$193.5K	$0
William Brown	PA	Foot Surgery Podiatrist	$168.1K	$19.8K
Kevin Colleran	PA	Orthopaedic Surgery Physician	$167.7K	$0
Thomas Roe	PA	Cardiovascular Disease Physician	$166.2K	$0
Kelly Williams	PA	Interventional Pain Medicine Physician	$150.2K	$14.4K

Geisinger Clinic — Billing Profile & Reimbursement Data

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Geisinger Clinic — 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