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.

Reading Hospital (NPI 1669530069)

Field	Value
Entity Type	Organization
Organization	Reading Hospital
Address	420 S 5th Ave
City	West Reading
State	PA
ZIP	19611
Taxonomy	General Acute Care Hospital
NPI Enumerated	December 5, 2006

Payer Source	Total Paid
Medicaid	$58.4M
Medicare	$0

Key Findings

This provider is effectively single-payer on the dataset: there is no Medicare billing on file while Total Medicaid revenue is $58.4M, so all reported legacy claims activity and revenue in our dataset come from Medicaid. The top 3 Medicaid codes by revenue account for 47.7% of this provider's total Medicaid revenue, indicating concentrated dependence on a small set of services for a large share of receipts.

The revenue mix and leading codes indicate an ED-centered acute-care footprint with extensive outpatient clinic activity. High-revenue emergency department evaluation-and-management codes (99284 at $9.8M and 99283) and the all-inclusive clinic code T1015 at $6.7M point to heavy ED throughput plus large-volume clinic/encounter billing; observation care (G0378 at $3.8M) and SARS‑CoV‑2 testing (U0003 at $4.3M) further underscore a hospital operating both inpatient/observation and high-volume ambulatory testing services.

Revenue concentration around a few codes is striking: the precomputed top-3 share is 47.7%, led by 99284 ($9.8M, 22.5%), T1015 ($6.7M, 15.3%), and U0003 ($4.3M, 9.9%). This concentration suggests that payer negotiations and utilization management focused on ED E/M, high-volume clinic encounters, and infectious-disease testing would materially affect the provider’s topline Medicaid performance.

On competitive standing within the state Medicaid market, READING HOSPITAL ranks at or near the top for multiple high-value codes. For example, 99284 ranks #12 of 1604 providers in-state (99th percentile; extreme outlier) and T1015 ranks #14 of 1691 (99th percentile; extreme outlier), while U0003 ranks #6 of 197 (97th percentile; notably above typical state volume), all signaling a dominant regional presence for these services.

Laboratory and diagnostic throughput is an important revenue stream beyond ED and clinic visits. Multiplex respiratory testing 87631 produced $2M in revenue and ranks #2 of 121 providers in-state (99th percentile; extreme outlier), and high claim counts for basic lab panels (85025 and 80053 with $455.7K and $436.9K respectively) place the hospital well above typical state volumes for outpatient and ED-directed testing.

The provider’s service mix includes substantial behavioral health and preventive care activity alongside acute services. Psychotherapy 90834 generated $2.4M (5.5% of Medicaid revenue) and ranks in the 90th percentile, while preventive codes 99391/99392/99393 each appear among the top ranks in-state (98th–99th percentile), indicating a broad outpatient care footprint that extends to mental health and well-child/adult preventive visits.

Observation capacity and high-acuity emergency care both contribute meaningful revenue: G0378 (hospital observation service) accounts for $3.8M (8.6%) and ranks #19 of 149 in-state (88th percentile; typical), while higher-acuity ED code 99285 produced $2.4M (5.4%) and ranks #46 of 1228 (96th percentile; notably above typical state volume). Together these codes point to an operational model that supports observation stays and management of higher-acuity ED presentations.

The provider has an established operational tenure in national enrollment records, with NPI enumerated 2006-12-05 (~20 years ago). That longstanding presence, combined with concentrated Medicaid revenue drivers and state-leading volumes on several codes, suggests the hospital is an entrenched Medicaid market participant whose contracting and utilization patterns will materially shape payer exposure in the region.

Medicaid: Complete Services Breakdown

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

572 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.	72,850	$140	$9.8M
T1015	Clinic visit/encounter, all-inclusive	117,150	$60	$6.7M
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…	48,720	$90	$4.3M
G0378	Hospital observation service, per hour	3,840	$980	$3.8M
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.	32,430	$100	$3.1M
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	37,960	$60	$2.4M
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.	14,060	$170	$2.4M
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	13,570	$140	$2M
X0621	N/A	6,150	$220	$1.4M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	7,920	$100	$792K

Showing 1–10 of 572

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

Reading Hospital — 17 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

572 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0039	Assertive community treatment, face-to-face, per 15 minutes	43	40	27,890	$150	$6.2M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	13	20	350	$1,720	$1.6M
G0378	Hospital observation service, per hour	19	150	510	$870	$1.4M
J2323	Injection, natalizumab, 1 mg	6	10	240	$2,130	$1.2M
T1015	Clinic visit/encounter, all-inclusive	14	1,690	760	$170	$1.2M
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	67	690	2,240	$80	$1M
J9271	Injection, pembrolizumab, 1 mg	15	20	420	$1,230	$827.7K
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…	26	130	310	$60	$769.3K
G9012	Other specified case management service not elsewhere classified	125	320	770	$260	$758K
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.	21	210	730	$40	$689.7K

Showing 1–10 of 572

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tower Health Medical Group	PA	Emergency Medicine Physician	$0	$8M
Gregory Emkey	PA	Rheumatology Physician	$1.4M	$0
Michael Lambo	PA	Radiation Oncology Physician	$1.1M	$0
Valerie Galante	PA	Adult Health Nurse Practitioner	$611.4K	$0
Le Wang	PA	Hematology (Internal Medicine) Physician	$270.4K	$0
Arun Kundra	PA	Clinical Cardiac Electrophysiology Physician	$257.8K	$8.3K
Shuaib Latif	CT	Clinical Cardiac Electrophysiology Physician	$248.6K	$10.8K
Balaji Shanmugam	FL	Interventional Cardiology Physician	$257.1K	$0
David Scollan	PA	Clinical Cardiac Electrophysiology Physician	$203.8K	$5.1K
Jared Green	PA	Cardiovascular Disease Physician	$161.9K	$11.9K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Penn State Health Medical Group, LLC	PA	Pediatrics Physician	$0	$7.7M
New Directions Treatment Services	PA	Methadone Clinic	$0	$6.3M
Tower Direct LLC	PA	Land Ambulance	$1.4M	$1.9M
William Kimmel	PA	Anatomic Pathology & Clinical Pathology Physician	$1.7M	$131.8K
Stephen Longenecker	PA	Orthopaedic Surgery Physician	$543.9K	$0
Eric Slotkin	PA	Orthopaedic Surgery Physician	$360.4K	$0
Kenneth Mcalpine	PA	Orthopaedic Surgery Physician	$261.8K	$0
Nathan Tiedeken	PA	Orthopaedic Surgery Physician	$247.9K	$0
Brian Tinsley	PA	Orthopaedic Hand Surgery Physician	$244.9K	$0
Ryan Michels	PA	Orthopaedic Trauma Physician	$206.9K	$0

Reading Hospital — Billing Profile & Reimbursement Data

Sign up for Reading Hospital — Billing Profile & Reimbursement Data policy alerts

Reading Hospital — Billing Profile & Reimbursement Data

Sign up for Reading Hospital — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References