Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
Home › PA › Harrisburg › NPI 1265537674
Hospital

UPMC Pinnacle Hospitals

UPMC Pinnacle Hospitals was paid $4.56M by Medicaid between Sep 2019 and Dec 2024, across 136 billing codes. Its largest line is 99284, emergency room visit (serious) — 37% of everything it billed.

33Billing provider infoUPMC PINNACLE HOSPITALS
HARRISBURG, PA 17109
33aNPI1265537674assigned 09/13/2006
33bProvider typeGeneral Acute Care Hospital
28Total paid$4.56M
24GClaims137,106
24DCodes billed136
24AFirst – last monthSep 2019 – Dec 2024
Compared with peers

Next to other General Acute Care Hospital providers in Pennsylvania

Rank by total paid#63 of 154
Median peer was paid$2.82M
This provider vs. median1.6×

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

$0$100K$200K$300K2018201920202021202220232024
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
YearClaimsPaid
2019553$8K
20209,418$275K
202163,011$2.01M
202223,799$865K
202325,300$812K
2024incomplete15,025$592K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 37% 16,298 15,810 $1.70M
G0378 Hospital observation service, per hour 17% 991 971 $795K
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 14% 8,696 8,490 $661K
99285 Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life 4.9% 2,265 2,183 $225K
74177 Computed tomography, abdomen and pelvis; with contrast material 3.3% 700 676 $149K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 1.9% 7,699 7,235 $87K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 1.9% 17,289 16,246 $86K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 1.5% 2,588 2,432 $69K
80053 Comprehensive metabolic panel 1.4% 6,334 5,945 $64K
80048 Basic metabolic panel (calcium, ionized) 1.1% 6,518 6,049 $50K
71275 Computed tomographic angiography, chest, with contrast material 1.1% 270 268 $48K
71046 Radiologic examination, chest; 2 views 1.0% 3,048 2,948 $46K
124 more codes
70450 Computed tomography, head or brain; without contrast material <1% 651 $43K
99282 Emergency department visit for the evaluation and management, low to moderate severity <1% 876 $37K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 2,608 $33K
84484 <1% 3,358 $29K
74176 Computed tomography, abdomen and pelvis; without contrast material <1% 264 $27K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc <1% 1,012 $26K
99281 Emergency department visit for the evaluation and management, self-limited or minor <1% 922 $23K
G0480 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed <1% 399 $22K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay <1% 443 $21K
96375 Therapeutic injection; each additional sequential IV push <1% 1,336 $18K
84443 Thyroid stimulating hormone (TSH) <1% 647 $13K
81001 <1% 4,244 $12K
83880 <1% 448 $11K
80061 Lipid panel <1% 791 $11K
71045 Radiologic examination, chest; single view <1% 1,089 $10K
93976 <1% 176 $10K
80050 General health panel <1% 257 $10K
96361 Intravenous infusion, hydration; each additional hour <1% 1,016 $9K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel <1% 212 $9K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 3,230 $9K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed <1% 297 $9K
83605 <1% 1,175 $8K
83690 <1% 1,885 $8K
76830 Ultrasound, transvaginal <1% 134 $7K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour <1% 250 $7K
93971 <1% 109 $6K
82728 <1% 550 $6K
84703 <1% 614 $6K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe <1% 209 $6K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe <1% 204 $6K
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 150 $5K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe <1% 133 $5K
83735 <1% 1,346 $5K
73610 <1% 227 $5K
82607 <1% 409 $5K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour <1% 148 $4K
84702 <1% 263 $4K
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 throughput technologies as described by cms-2020-01-r <1% 61 $4K
83540 <1% 542 $4K
72125 Computed tomography, cervical spine; without contrast material <1% 71 $4K
87086 Culture, bacterial; quantitative colony count, urine <1% 585 $4K
85027 <1% 922 $4K
83036 Hemoglobin; glycosylated (A1C) <1% 599 $4K
76857 <1% 117 $4K
73630 <1% 223 $3K
85379 <1% 302 $3K
80076 <1% 373 $3K
83550 <1% 537 $3K
76801 <1% 57 $3K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal <1% 44 $3K
73030 <1% 139 $3K
73130 <1% 160 $2K
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source <1% 525 $2K
87040 <1% 178 $2K
85610 <1% 762 $2K
86900 <1% 264 $2K
72100 <1% 84 $2K
84439 <1% 257 $2K
82746 <1% 181 $2K
71260 Computed tomography, thorax, diagnostic; with contrast material <1% 13 $2K
73564 <1% 74 $2K
85730 <1% 324 $2K
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes <1% 70 $2K
86140 <1% 546 $2K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance <1% 42 $1K
86901 <1% 264 $1K
82570 <1% 181 $1K
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 6,780 $1K
85652 <1% 431 $1K
96376 <1% 344 $1K
73110 <1% 59 $1K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete <1% 27 $993.72
73590 <1% 42 $842.55
73560 <1% 41 $824.07
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies <1% 28 $813.47
82043 <1% 104 $802.88
J3490 Unclassified drugs <1% 1,111 $801.01
90715 <1% 107 $778.55
83615 <1% 114 $741.38
86038 <1% 39 $564.28
84100 <1% 223 $522.62
87081 <1% 88 $509.33
87186 <1% 73 $498.07
86803 <1% 29 $472.93
87077 <1% 78 $471.28
J2270 Injection, morphine sulfate, up to 10 mg <1% 1,049 $426.76
99000 <1% 87 $420.21
73090 <1% 18 $351.05
74018 <1% 25 $305.22
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 53 $270.79
73502 <1% 14 $267.33
73070 <1% 12 $262.90
J0696 Injection, ceftriaxone sodium, per 250 mg <1% 764 $243.09
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 1,361 $225.96
74022 <1% 13 $221.80
82550 <1% 34 $207.36
J2405 Injection, ondansetron hydrochloride, per 1 mg <1% 2,500 $204.17
86850 <1% 46 $201.14
J2704 Injection, propofol, 10 mg <1% 486 $192.71
80143 <1% 15 $162.32
80179 <1% 14 $162.32
87340 <1% 13 $134.61
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 12 $108.60
J1170 Injection, hydromorphone, up to 4 mg <1% 184 $100.24
J1200 Injection, diphenhydramine hcl, up to 50 mg <1% 822 $87.07
J0780 Injection, prochlorperazine, up to 10 mg <1% 213 $83.19
J3010 Injection, fentanyl citrate, 0.1 mg <1% 595 $74.61
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml <1% 13 $71.42
Q0162 Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen <1% 3,111 $69.89
86431 <1% 12 $68.41
J3475 Injection, magnesium sulfate, per 500 mg <1% 194 $68.10
J1650 Injection, enoxaparin sodium, 10 mg <1% 110 $66.63
J7512 Prednisone, immediate release or delayed release, oral, 1 mg <1% 839 $66.29
81025 <1% 17 $53.20
J2060 Injection, lorazepam, 2 mg <1% 190 $51.99
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg <1% 30 $44.43
81003 <1% 12 $37.51
T1015 A visit at a community health center or clinic (one all-in rate) <1% 16 $37.45
J0690 Injection, cefazolin sodium, 500 mg <1% 283 $35.39
J1644 Injection, heparin sodium, per 1000 units <1% 118 $31.31
J2765 Injection, metoclopramide hcl, up to 10 mg <1% 323 $26.30
J2250 Injection, midazolam hydrochloride, per 1 mg <1% 361 $7.29
Q0163 Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen <1% 56 $6.83
36415 Collection of venous blood by venipuncture <1% 98 $3.96

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, PHLIP (PRESIDENT AND CEO)