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.

University Of Penn-medical Group (NPI 1952799074)

Field	Value
Entity Type	Organization
Organization	University Of Penn-medical Group
Address	3400 Spruce St
City	Philadelphia
State	PA
ZIP	19104
Taxonomy	Emergency Medicine Physician
NPI Enumerated	December 23, 2014

Payer Source	Total Paid
Medicaid	$21.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

11 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.	153,680	$90	$14M
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.	59,880	$110	$6.6M
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.	12,040	$70	$782.5K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	440	$180	$79.4K
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.	630	$40	$24.6K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	140	$70	$9.6K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	40	$110	$4.4K
99255	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends at…	10	$200	$2.6K
99281	The provider sees a patient for the lowest level emergency department visit.	80	$20	$1.7K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	20	$30	$510

Showing 1–10 of 11

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

University Of Penn-medical Group — 2 of 11 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

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	3	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.	83	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.	6	1,230	250	$130	$284K
99281	The provider sees a patient for the lowest level emergency department visit.	79	120	190	$130	$90.3K
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.	108	340	250	$80	$89K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	42	250	80	$140	$74.1K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	463	510	250	$40	$56.2K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	437	610	90	$60	$50.1K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	596	1,300	110	$40	$41.5K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	688	880	320	$10	$19.5K

Showing 1–10 of 11

Related Providers

Other providers that share a Tax Identification Number (TIN) with University Of Penn-medical Group, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ohiohealth Corporation	OH	Family Medicine Physician	$0	$89.1M
Trustees Of The University Of Pennsylvania	PA	General Acute Care Hospital	$0	$84M
University Of Penn-medical Group	PA	Diagnostic Radiology Physician	$0	$17.7M
Imaging Subspecialists Of North Jersey, LLC	NJ	Diagnostic Radiology Physician	$0	$7.5M
Trustees Of The University Of Pennsylvania	PA	Home Infusion Agency	$159.1K	$7.2M
Peter Bracha	FL	Retina Specialist (Ophthalmology) Physician	$4M	$0
Bruce Saran	PA	Ophthalmology Physician	$2.9M	$0
University Of Penn-medical Group	PA	Clinical Medical Laboratory	$1.2M	$1.3M
Jason Ruggiero	VA	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
Aimee Krausz	PA	Dermatology Physician	$1.4M	$0

Nearby Providers

Other providers in the same ZIP code as University Of Penn-medical Group, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Childrens Hospital Of Philadelphia	PA	Children's Hospital	$0	$286.9M
House House Rehabilitation Services	PA	Community/Behavioral Health Agency	$0	$32.8M
Childrens Health Care Associates, Inc	PA	Pediatric Emergency Medicine (Emergency Medicine) Physician	$0	$24.2M
Presbyterian Medical Center Of The University Of Pennsylvania Health S	PA	General Acute Care Hospital	$0	$23.3M
Horizon House, Inc.	PA	Community/Behavioral Health Agency	$0	$13.9M
Tricounty Medical Equipment And Supply, LLC	PA	Durable Medical Equipment & Medical Supplies	$0	$13.1M
Dunbar Strategic Consulting Group	PA	Community/Behavioral Health Agency	$0	$10.8M
Intercultural Family Services, Inc.	PA	Health Service Psychologist	$0	$10.7M
Aspire Autism Inc.	PA	Community/Behavioral Health Agency	$0	$9.9M
Childrens Health Care Associates, Inc	PA	Neonatal-Perinatal Medicine Physician	$0	$8.8M

University Of Penn-medical Group — 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