Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidErnest Sully
    Ask Trek AI about this page

    Ernest Sully — Billing Profile & Reimbursement Data

    NPI 1730214172 · Montgomeryville, PA · Emergency Medicine Physician

    Customize your policy alerts

    Sign up for Ernest Sully — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Ernest Sully is a emergency medicine physician provider located in Montgomeryville, Pennsylvania. This profile covers 27 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationErnest Sully
    Address713 Bethlehem Pike
    CityMontgomeryville
    StatePA
    ZIP18936
    TaxonomyEmergency Medicine Physician
    NPI EnumeratedFebruary 23, 2007

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$82.1K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    27 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99214The 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…180$80$14.6K
    99204The 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…120$100$11.9K
    99213The 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…190$60$11.1K
    87428The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…180$50$9.6K
    99203The provider sees a new 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 provider…100$70$6.7K
    99205The 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…40$150$5.4K
    99215The 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…40$130$4.7K
    71046In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…160$20$3.4K
    87426The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…70$40$2.6K
    87804The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.140$20$2.3K

    Showing 1–10 of 27

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 27 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    27 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992147,61523,230100$80$14.5K
    992153,5977,17040$120$8.6K
    85025243420100$10$8.4K
    992134,43722,37070$60$7.7K
    9920458310,29030$110$5K
    992058393,09020$150$4.9K
    992038657,33030$70$3.5K
    364151,0842,34080$10$3.2K
    87428428030$60$2.3K
    992123,3214,72030$40$2.3K

    Showing 1–10 of 27

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    St. Luke's HospitalPAGeneral Acute Care Hospital$0$23.4M
    St Lukes HospitalPAGeneral Acute Care Hospital$0$20.8M
    Patient First Pennsylvania Medical Group PLLCVAUrgent Care Clinic/Center$0$14.6M
    Patient First Richmond Physician's Group PCVAUrgent Care Clinic/Center$0$11.1M
    The Carbon-schuylkill Community Hospital, Inc.PAGeneral Acute Care Hospital$0$8.6M
    St Lukes Hospital-anderson CampusPAGeneral Acute Care Hospital$0$8.5M
    St Luke's HospitalPAGeneral Acute Care Hospital$0$7M
    Patient First Pennsylvania Medical Group PLLCPAFamily Medicine Physician$0$5.6M
    Joseph ZaladonisPASpecialist$1.4M$0
    Yong KeNYAnatomic Pathology & Clinical Pathology Physician$351.6K$802.7K

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Caresense Health LLCPAHome Health Agency$0$37.2M
    United Seating And Mobility LLCPADurable Medical Equipment & Medical Supplies$0$6.6M
    Mohammed IslamPAInternal Medicine Physician$254K$20.3K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Pennsylvania Distribution
    Ernest Sully — 3 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Pennsylvania