Pinnacle Health Medical Services
Pinnacle Health Medical Services was paid $375K by Medicaid between Oct 2020 and Dec 2024, across 10 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 55% of everything it billed.
YORK, PA 17402
Next to other Advanced Practice Midwife 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 | |
|---|---|---|---|
| 2020 | 375 | $21K | |
| 2021 | 2,492 | $147K | |
| 2022 | 1,440 | $75K | |
| 2023 | 1,732 | $78K | |
| 2024incomplete | 1,259 | $54K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 55% | 3,734 | 3,457 | $207K |
| 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 | 26% | 1,272 | 1,182 | $96K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 12% | 903 | 848 | $45K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 2.6% | 112 | 91 | $10K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1.2% | 215 | 213 | $4K |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | 1.1% | 227 | 225 | $4K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 71 | 71 | $2K |
| 81025 | <1% | 451 | 438 | $2K | |
| 0502F | <1% | 228 | 168 | $2K | |
| 90715 | <1% | 85 | 78 | $2K |
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 |
| 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 | Ephrata, PA | $79K |
| 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.