Pinnacle Health Medical Services
Pinnacle Health Medical Services was paid $79K by Medicaid between Mar 2022 and Nov 2024, across 6 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 75% of everything it billed.
EPHRATA, PA 17522
Next to other Family Medicine Physician providers in Pennsylvania
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2022 | 365 | $13K | |
| 2023 | 641 | $33K | |
| 2024incomplete | 542 | $33K |
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 | 75% | 994 | 934 | $59K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 24% | 495 | 477 | $19K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 12 | 12 | $493.00 |
| 92551 | <1% | 16 | 16 | $114.40 | |
| 99173 | <1% | 16 | 16 | $93.00 | |
| 96160 | <1% | 15 | 15 | $42.98 |
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.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| Pinnacle Health Cardiovascular Institute INC | Wormleysburg, PA | $1.86M |
| Pinnacle Health Medical Services | Lancaster, PA | $887K |
| Pinnacle Health Medical Services | Mechanicsburg, PA | $775K |
| Pinnacle Health Medical Services | Harrisburg, PA | $557K |
| Wellspan Medical Group | York, PA | $501K |
| Pinnacle Health Medical Services | York, PA | $375K |
| Wellspan Medical Group | York, PA | $212K |
| Wellspan Medical Group | York, PA | $150K |
| Wellspan Medical Group | Aspers, PA | $138K |
| Wellspan Medical Group | Gettysburg, PA | $90K |
| Wellspan Medical Group | Gettysburg, PA | $87K |
| Pinnacle Health Medical Services | Harrisburg, PA | $69K |
| Pinnacle Health Medical Services | Harrisburg, PA | $53K |
| Wellspan Medical Group | York, PA | $47K |
| Pinnacle Health Medical Services | York, PA | $37K |
| Pinnacle Health Medical Services | Lititz, PA | $29K |
| Pinnacle Health Medical Services | Carlisle, PA | $27K |
| Pinnacle Health Medical Services | Hummelstown, PA | $22K |
| Pinnacle Health Medical Services | Enola, PA | $19K |
| Pinnacle Health Medical Services | Harrisburg, PA | $18K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.