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.

Pottstown Hospital, LLC (NPI 1649794421)

Field	Value
Entity Type	Organization
Organization	Pottstown Hospital, LLC
Address	1600 E High St
City	Pottstown
State	PA
ZIP	19464
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 2, 2017

Payer Source	Total Paid
Medicaid	$7.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

123 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.	16,050	$210	$3.4M
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.	11,930	$220	$2.6M
G0378	Hospital observation service, per hour	790	$930	$735.2K
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.	1,160	$170	$197.9K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	480	$230	$106.9K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	600	$110	$63.4K
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.	430	$90	$36.5K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	7,980	$1	$31.9K
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.	3,940	$10	$31.5K
T1015	Clinic visit/encounter, all-inclusive	570	$50	$25.7K

Showing 1–10 of 123

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

Pottstown Hospital, LLC — 1 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

123 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	60	150	510	$870	$1.4M
T1015	Clinic visit/encounter, all-inclusive	901	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…	69	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.	107	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…	147	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.	81	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.	84	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.	257	1,230	250	$130	$284K
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.	177	480	260	$90	$115.3K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	100	190	2,160	$30	$95.7K

Showing 1–10 of 123

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Youval Katz	PA	Hematology & Oncology Physician	$982.3K	$0
Le Wang	PA	Hematology (Internal Medicine) Physician	$270.4K	$0

Nearby Providers

Other providers in the same ZIP code as Pottstown Hospital, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Creative Health Services Inc	PA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$23.4M
Penn Foundation Inc	PA	Community/Behavioral Health Agency	$0	$5.6M
Goodwill Steam Fire Engine Co - 1	PA	Ambulance	$700.4K	$2.2M
An Pham	PA	Pulmonary Disease Physician	$1.3M	$26K
Michael Lambo	PA	Radiation Oncology Physician	$1.1M	$0
Scot Paris	PA	Surgery Physician	$1M	$0
Nikos Pavlides	PA	Orthopaedic Surgery Physician	$448.3K	$0
Pottstown Ambulatory Center, LLC	PA	Ambulatory Surgical Clinic/Center	$435.2K	$0
Navneet Sharma	PA	Internal Medicine Physician	$384.5K	$0
John Louis	PA	Plastic and Reconstructive Surgery Physician	$351.7K	$0

Pottstown Hospital, LLC — Billing Profile & Reimbursement Data

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Pottstown Hospital, LLC — 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