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.

Lehigh Valley Hospital (NPI 1952954307)

Field	Value
Entity Type	Organization
Organization	Lehigh Valley Hospital
Address	1200 S Cedar Crest Blvd
City	Allentown
State	PA
ZIP	18103
Taxonomy	Children's Hospital
NPI Enumerated	July 24, 2019

Payer Source	Total Paid
Medicaid	$10M
Medicare	$0

Medicaid: Complete Services Breakdown

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

68 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.	13,840	$280	$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.	17,610	$190	$3.3M
G0378	Hospital observation service, per hour	710	$2,450	$1.7M
T1015	Clinic visit/encounter, all-inclusive	5,450	$50	$294.4K
D2930	N/A	160	$1,410	$225.3K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	160	$910	$145.3K
54161	The provider excises the foreskin of a patient older than 28 days; the provider uses a technique other than a clamp, other devices, or dorsal slit.	340	$370	$124.5K
14040	The provider repairs lesions in the patient’s forehead, cheeks, chin, mouth, neck, axillae or armpits, genitalia, hands, and/or feet by using healthy tissues from an adjacent site. This code…	60	$1,380	$88K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	110	$470	$51.1K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	530	$70	$37.4K

Showing 1–10 of 68

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

Lehigh Valley Hospital — 2 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

68 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J1745	Injection, infliximab, excludes biosimilar, 10 mg	14	20	350	$1,720	$1.6M
G0378	Hospital observation service, per hour	65	150	510	$870	$1.4M
T1015	Clinic visit/encounter, all-inclusive	325	1,690	760	$170	$1.2M
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…	171	200	990	$70	$517.5K
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.	93	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.	50	1,060	150	$130	$405.4K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	10	30	60	$1,390	$305.3K
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.	769	1,230	250	$130	$284K
D2930	N/A	130	200	290	$200	$223.1K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	19	50	70	$620	$190.6K

Showing 1–10 of 68

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lehigh Valley Hospital	PA	General Acute Care Hospital	$0	$64.3M
Paul Gross	PA	Psychiatry Physician	$224.7K	$0
Kenneth Cavorsi	PA	Diagnostic Radiology Physician	$183.9K	$330
Matthew Brown	PA	Diagnostic Radiology Physician	$169.4K	$0
Lehigh Valley Hospital	PA	Diagnostic Radiology Physician	$153.3K	$0
Joel Ninos	PA	Physical Therapist	$142.3K	$0
Nathan Himes	MA	Diagnostic Radiology Physician	$134.2K	$0
Mark Osborne	PA	Diagnostic Radiology Physician	$133.5K	$0
Shibu Philips	PA	Nuclear Imaging & Therapy Physician	$128.4K	$0
Joshua Bemporad	PA	Diagnostic Radiology Physician	$127.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lehigh Valley Physician Group	PA	Emergency Medicine Physician	$0	$16.3M
Preferred Home Health Care & Nursing Services Inc.	PA	Home Health Agency	$0	$12.1M
Efcc Acquisition Corp	PA	Home Health Agency	$0	$9.6M
Medical Imaging Of Lehigh Valley PC	PA	Diagnostic Radiology Physician	$0	$9.5M
Lehigh Valley Physician Group	PA	Pediatric Emergency Medicine (Emergency Medicine) Physician	$0	$5.9M
Masayuki Kazahaya	PA	Ophthalmology Physician	$3.7M	$0
Ya-yu Lee	PA	Endocrinology, Diabetes & Metabolism Physician	$831K	$0
Neil Feldman	PA	Allergy Physician	$808K	$1.6K
Susan Kim	PA	Rheumatology Physician	$770.1K	$0
Steven Oberlender	PA	MOHS-Micrographic Surgery Physician	$760K	$0

Lehigh Valley Hospital — Billing Profile & Reimbursement Data

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Lehigh Valley Hospital — 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