Physician
Pinnacle Health Regional Physicians
Pinnacle Health Regional Physicians was paid $1.84M by Medicaid between Jan 2018 and Feb 2024, across 43 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 47% of everything it billed.
33Billing provider infoPINNACLE HEALTH REGIONAL PHYSICIANS
HARRISBURG, PA 17104
HARRISBURG, PA 17104
33aNPI1013441690assigned 04/20/2017
33bProvider typeUrology Physician
28Total paid$1.84M
24GClaims46,188
24DCodes billed43
24AFirst – last monthJan 2018 – Feb 2024
Compared with peers
Next to other Urology Physician providers in Pennsylvania
Rank by total paid#2 of 134
Median peer was paid$3K
This provider vs. median583×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 457 | $10K | |
| 2019 | 558 | $20K | |
| 2020 | 4,082 | $154K | |
| 2021 | 19,144 | $765K | |
| 2022 | 17,101 | $703K | |
| 2023 | 4,797 | $183K | |
| 2024incomplete | 49 | $1K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 47% | 14,981 | 14,177 | $859K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 44% | 20,484 | 18,743 | $815K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.6% | 655 | 615 | $29K |
| 90682 | 1.2% | 618 | 611 | $22K | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 1,749 | 1,410 | $15K |
| 90715 | <1% | 750 | 742 | $13K | |
| 90651 | <1% | 242 | 239 | $9K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 856 | 776 | $8K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 136 | 135 | $8K |
| 90670 | <1% | 377 | 373 | $7K | |
| 90674 | <1% | 878 | 860 | $7K | |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | <1% | 76 | 76 | $7K |
31 more codes
| 80305 | <1% | 435 | $5K | |
| 20610 | <1% | 194 | $4K | |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 27 | $4K |
| 90686 | <1% | 296 | $4K | |
| 11721 | <1% | 187 | $3K | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 615 | $2K |
| 81003 | <1% | 627 | $2K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 75 | $2K |
| 90732 | <1% | 14 | $1K | |
| 81025 | <1% | 285 | $1K | |
| 90734 | <1% | 195 | $994.00 | |
| 90698 | <1% | 182 | $921.00 | |
| 90633 | <1% | 101 | $844.00 | |
| 76830 | Ultrasound, transvaginal | <1% | 12 | $660.64 |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 18 | $628.00 |
| 36415 | Collection of venous blood by venipuncture | <1% | 462 | $623.20 |
| 86580 | <1% | 189 | $468.12 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 29 | $465.07 |
| 93000 | <1% | 24 | $418.58 | |
| 92551 | <1% | 52 | $409.60 | |
| 90680 | <1% | 53 | $389.00 | |
| 99173 | <1% | 66 | $373.50 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 12 | $372.00 |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | <1% | 24 | $337.22 |
| 99499 | <1% | 17 | $299.00 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 59 | $168.05 |
| 90744 | <1% | 41 | $150.00 | |
| 90710 | <1% | 13 | $148.00 | |
| 90688 | <1% | 13 | $142.60 | |
| 96127 | <1% | 12 | $49.60 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 57 | $0.96 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialGUARNESCHELLI, PHIL (CEO)