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.

Upmc Altoona (NPI 1649278730)

Field	Value
Entity Type	Organization
Organization	Upmc Altoona
Address	620 Howard Ave.
City	Altoona
State	PA
ZIP	16601
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 12, 2005

Payer Source	Total Paid
Medicaid	$19.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

465 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.	31,750	$150	$4.7M
T1015	Clinic visit/encounter, all-inclusive	61,400	$30	$2.1M
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.	16,370	$100	$1.6M
G0378	Hospital observation service, per hour	5,450	$280	$1.5M
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.	7,810	$180	$1.4M
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…	4,840	$90	$425.6K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	3,610	$90	$324.4K
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.	2,450	$130	$316.4K
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.	33,970	$10	$305.7K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	140	$2,140	$297K

Showing 1–10 of 465

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

Upmc Altoona — 8 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

465 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	5	10	770	$1,290	$1.6M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	18	20	350	$1,720	$1.6M
G0378	Hospital observation service, per hour	11	150	510	$870	$1.4M
T1015	Clinic visit/encounter, all-inclusive	43	1,690	760	$170	$1.2M
J9271	Injection, pembrolizumab, 1 mg	16	20	420	$1,230	$827.7K
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.	39	210	730	$40	$689.7K
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…	85	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.	38	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.	58	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.	88	1,230	250	$130	$284K

Showing 1–10 of 465

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
George Jabbour	PA	Cardiovascular Disease Physician	$882.6K	$732.1K
Ziad Khoury	PA	Cardiovascular Disease Physician	$1.1M	$151.8K
Hany Shanoudy	PA	Cardiovascular Disease Physician	$571.3K	$108.8K
Michael Larkin	PA	Cardiovascular Disease Physician	$414.1K	$192.2K
Mehrdad Ghaffari	PA	Sleep Medicine (Family Medicine) Physician	$172.6K	$219.9K
Stacy Emile	PA	Family Medicine Physician	$324.7K	$0
Arthur Demarsico	NJ	Vascular Surgery Physician	$310.2K	$0
Nicholas Madden	PA	Surgery Physician	$156K	$134K
Michael Zlupko	PA	Pulmonary Disease Physician	$158.9K	$37.5K
Christopher Hartwell	PA	Emergency Medicine Physician	$158.7K	$10.1K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Primary Health Network	PA	Federally Qualified Health Center (FQHC)	$0	$19.7M
Pyramid Healthcare Inc.	PA	Methadone Clinic	$125.2K	$13.3M
Upmc Home Healthcare Of Central Pennsylvania	PA	Home Health Agency	$0	$7.1M
David Rose	PA	Diagnostic Radiology Physician	$137.1K	$209.6K
Alan Kanouff	PA	Pulmonary Disease Physician	$212.7K	$49.1K
Angel Raposas	PA	Nephrology Physician	$218.7K	$21.1K
Robert Caughey	PA	Otolaryngology Physician	$49.6K	$126.8K
Jeffrey Farrell	PA	Vascular & Interventional Radiology Physician	$71.5K	$86.5K
Gorgi Kozeski	PA	Clinical Cardiac Electrophysiology Physician	$143.9K	$11.4K
Thompson Enterprises, Inc.	PA	Community/Retail Pharmacy	$147.7K	$780

Upmc Altoona — Billing Profile & Reimbursement Data

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Upmc Altoona — 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