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 Washington for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Washington 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. Washington (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.

Pinnacle Pain Center, Ps (NPI 1740434356)

Pinnacle Pain Center, Ps is a pain medicine (anesthesiology) physician provider located in Kennewick, Washington. This profile covers 0 Medicare and 47 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Pinnacle Pain Center, Ps
Address	7401 W Hood Place
City	Kennewick
State	WA
ZIP	99336
Taxonomy	Pain Medicine (Anesthesiology) Physician
NPI Enumerated	November 10, 2008

Payer Source	Total Paid
Medicaid	$11.6M
Medicare	$0

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

47 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	100,780	$40	$4.4M
G0481	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…	23,530	$120	$2.8M
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.	42,890	$50	$2.3M
G0482	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…	6,610	$130	$886.3K
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…	2,210	$100	$214.3K
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…	2,620	$70	$190.9K
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…	6,000	$30	$186.1K
99443	N/A	3,170	$50	$152K
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.	6,950	$10	$62.5K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	310	$160	$50K

Showing 1–10 of 47

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Washington providers billing the same CPT/HCPCS codes.

Claims Volume vs. Washington Distribution

Pinnacle Pain Center, Ps — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. Washington median

47 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0482	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…	5	20	1,010	$140	$3M
G0481	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…	5	30	660	$100	$1.5M
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.	12	170	2,120	$40	$779.1K
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…	41	90	1,760	$50	$601.4K
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…	18	1,820	480	$60	$379.6K
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…	336	1,860	610	$40	$295.5K
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…	118	540	130	$90	$128.6K
99203	The 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…	200	560	140	$70	$88.9K
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…	38	530	80	$90	$87.4K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	24	50	310	$70	$74.7K

Showing 1–10 of 47

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Steven Larsen	UT	Interventional Pain Medicine Physician	$360.8K	$0
Virginia Lynch	WA	Nurse Practitioner	$275.3K	$0
William Waites	WA	Physician Assistant	$217K	$0
Patrick Demarco	WA	Clinical Psychologist	$123.1K	$0
Vienna Loften	WA	Family Nurse Practitioner	$120K	$0
Greg Wilkinson	CA	Physician Assistant	$102.4K	$0
Elise Pedigo	NM	Physician Assistant	$67.7K	$0
Regina Marie Kendra	ID	Nurse Practitioner	$55.4K	$0
Kyle Schoenberger	NM	Interventional Pain Medicine Physician	$48.6K	$0
Amanda Renfro	NM	Nurse Practitioner	$37.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ideal Option, PLLC	WA	Clinic/Center	$0	$259.1M
Ideal Option, PLLC	WA	Clinical Medical Laboratory	$0	$39.2M
Yakima Valley Farm Workers Clinic	WA	Dentist	$0	$20.5M
City Of Kennewick	WA	Ambulance	$906.2K	$11.5M
Lutheran Community Services Northwest	WA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$10.4M
Three Rivers Therapy, LLC	WA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.7M
Tri-cities Laboratory, LLC	WA	Clinical Medical Laboratory	$0	$8.7M
Columbia Physical Therapy Inc Ps	WA	Physical Therapist	$0	$6.7M
Ideal Balance PLLC	WA	Substance Use Disorder Rehabilitation Clinic/Center	$0	$5.3M
Qualicenters Inland Northwest L.L.C.	WA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$5.1M

Pinnacle Pain Center, Ps — Billing Profile & Reimbursement Data

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Pinnacle Pain Center, Ps — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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