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

Why is the Medicaid comparison limited to Mississippi 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. Mississippi (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 Medical Solutions, LLC (NPI 1770512501)

Field	Value
Entity Type	Organization
Organization	Pinnacle Medical Solutions, LLC
Address	7165 Getwell Rd Bldg G
City	Southaven
State	MS
ZIP	38672
Taxonomy	Durable Medical Equipment & Medical Supplies
NPI Enumerated	July 2, 2006

Payer Source	Total Paid
Medicaid	$74.5M
Medicare	$0

Key Findings

This provider has no Medicare billing on file; its entire reported lifetime federal revenue base is effectively single-payer Medicaid, which totals $74.5M. Analysts should treat PINNACLE MEDICAL SOLUTIONS, LLC as a Medicaid-focused DME/MS supplier when modeling payer mix, reimbursement exposure, and contractual leverage.

Revenue concentration is extremely high: the precomputed top 3 Medicaid codes account for 74.1% of this provider's total Medicaid revenue. The single largest code, A9276, alone represents $37.4M (50.2% of total Medicaid revenue), followed by A9277 at $11M (14.7%) and A9274 at $6.8M (9.2%), indicating the business is heavily dependent on a narrow set of product lines.

The code mix and descriptions indicate a focused business model centered on diabetes management and ambulatory infusion services: A9276 and A9277 are continuous glucose monitoring (CGM) sensor and transmitter components, while A9274, A4230, A4239, K0553 and related codes reflect disposable external insulin delivery and pump supplies. This suggests the provider operates as a high-volume supplier of CGM sensors, transmitters, receivers and insulin pump consumables rather than as a broad-spectrum DME supplier.

Competitive standing within Mississippi is dominant for multiple high-revenue codes: PINNACLE ranks #1 in-state for A9276, A9277, A9274, A4222, A4230, A9278, K0553 and several others and frequently sits at the 100th percentile or near it. Several of those #1 rankings carry the explicit label "notably above typical state volume" or equivalent; this positions the provider as a market leader in CGM and pump supplies in-state and a primary source for those products to Medicaid beneficiaries.

There are a few high-volume comparisons that reinforce statewide dominance beyond the headline codes: A4253 (blood glucose strips) shows 15.9K claims and ranks #4 of 127 providers in-state at the 98th percentile, which indicates the provider also moves substantial volumes through ancillary diabetes supply lines. Conversely, several HCPCS where it is the only reporting provider (e.g., A4230, A4232, A4231, A4225, A4224) lack statewide peer volume comparisons—those codes may reflect product lines or billing practices with limited competition or reporting in Mississippi.

The provider’s tenure is long-standing: the NPI was enumerated on 2006-07-02 (~20 years ago). That duration supports interpretation of sustained operational presence in the Medicaid market and gives context to its accumulation of high volumes and market share for diabetes-related DME supplies.

From a commercial risk and operations perspective, the extreme revenue concentration in CGM sensors and pump supplies (A9276, A9277, A9274) implies vulnerability to changes in Medicaid coverage policy, reimbursement rates, or supply contracting for those specific codes. Any payer-level shifts in reimbursement methodology, prior authorization, or preferred supplier lists for CGM and insulin delivery systems could materially affect this provider’s Medicaid revenue given that the top three codes together make up 74.1% of its Medicaid receipts.

Medicaid: Complete Services Breakdown

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

28 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
A9276	Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply	104,760	$360	$37.4M
A9277	Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system	27,310	$400	$11M
A9274	External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories	17,820	$380	$6.8M
A4222	Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)	12,860	$500	$6.5M
E0784	External ambulatory infusion pump, insulin	3,020	$1,270	$3.8M
A4230	Infusion set for external insulin pump, non needle cannula type	22,590	$130	$2.9M
A9278	Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system	4,220	$370	$1.6M
A4253	Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips	15,880	$70	$1M
K0553	Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service	16,450	$50	$888.1K
A4239	Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service	14,880	$60	$833.4K

Showing 1–10 of 28

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Mississippi Distribution

Pinnacle Medical Solutions, LLC — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Mississippi

Full comparison — all codes billed, vs. Mississippi median

28 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A9276	Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply	1	10	1,960	$360	$8M
A9277	Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system	1	10	1,270	$410	$3.9M
A9274	External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories	1	10	9,610	$390	$3.7M
A4230	Infusion set for external insulin pump, non needle cannula type	1	10	22,590	$130	$2.9M
E0784	External ambulatory infusion pump, insulin	1	10	1,630	$1,430	$2.3M
A4222	Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)	1	10	1,180	$370	$990.6K
A9278	Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system	1	10	390	$380	$595.5K
A6257	Transparent film, sterile, 16 sq. in. or less, each dressing	1	10	4,250	$70	$297.6K
A4239	Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service	1	10	380	$70	$214.7K
A4232	Syringe with needle for external insulin pump, sterile, 3 cc	1	10	14,380	$10	$210.5K

Showing 1–10 of 28

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Diabetes Supply Center Of The Midlands LLC	NE	Durable Medical Equipment & Medical Supplies	$0	$40.7M
Pinnacle Medical Solutions LLC	AL	Durable Medical Equipment & Medical Supplies	$0	$4.4M

Nearby Providers

Other providers in the same ZIP code as Pinnacle Medical Solutions, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mississippi Behavior Services	MS	Behavior Analyst	$0	$11.1M
City Home Care, LLC	MS	Home Health Agency	$0	$4.8M
Jeff Moye Inc.	MS	Physical Therapist	$0	$3.1M
North Mississippi Dental Specialists, PLLC	MS	Pediatric Dentistry	$0	$2.3M
Journey To New Beginnings, PLLC	MS	Clinical Social Worker	$0	$1.3M
Robert Skinner	MS	Family Medicine Physician	$567.5K	$0
Ki Chang	MS	Internal Medicine Physician	$223.8K	$0
Teresa Kendrick	MS	Psychiatric/Mental Health Nurse Practitioner	$174.7K	$0
Rashmi Pandya-lipman	MS	Ophthalmology Physician	$6.7K	$154.7K
Jeff Cunningham	MS	Otolaryngology Physician	$117.6K	$0

Pinnacle Medical Solutions, LLC — Billing Profile & Reimbursement Data

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Pinnacle Medical Solutions, LLC — Billing Profile & Reimbursement Data

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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