Physician
Pinnacle Care Providers, LLC
Pinnacle Care Providers, LLC was paid $1.66M by Medicaid between Jan 2018 and Dec 2024, across 38 billing codes. Its largest line is 99308, Subsequent nursing facility care, per day, straightforward — 45% of everything it billed.
33Billing provider infoPINNACLE CARE PROVIDERS, LLC
CANTON, OH 44702
CANTON, OH 44702
33aNPI1578799417assigned 06/05/2009
33bProvider typeFamily Medicine Physician
28Total paid$1.66M
24GClaims182,191
24DCodes billed38
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in Ohio
Rank by total paid#46 of 739
Median peer was paid$30K
This provider vs. median56×
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 | 14,616 | $121K | |
| 2019 | 18,344 | $129K | |
| 2020 | 11,476 | $97K | |
| 2021 | 14,971 | $201K | |
| 2022 | 41,141 | $594K | |
| 2023 | 51,663 | $279K | |
| 2024incomplete | 29,980 | $237K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99308 | Subsequent nursing facility care, per day, straightforward | 45% | 73,903 | 43,773 | $738K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 43% | 51,309 | 28,500 | $712K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 3.5% | 4,455 | 2,093 | $58K |
| 99222 | Initial hospital care, per day, moderate complexity | 2.3% | 1,074 | 924 | $38K |
| 99306 | Prolong nursin fac eval 15m | 1.9% | 1,354 | 1,219 | $31K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 1.0% | 917 | 508 | $17K |
| 99304 | <1% | 722 | 677 | $10K | |
| 99223 | Prolong inpt eval add15 m | <1% | 156 | 119 | $9K |
| 99348 | <1% | 1,190 | 805 | $8K | |
| 99349 | <1% | 801 | 463 | $7K | |
| 99335 | <1% | 1,701 | 1,074 | $7K | |
| 99307 | <1% | 943 | 778 | $6K |
26 more codes
| 99490 | Ccm add 20min | <1% | 921 | $5K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 187 | $4K |
| 99305 | <1% | 202 | $3K | |
| 99334 | <1% | 140 | $2K | |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | <1% | 239 | $2K |
| 99318 | <1% | 66 | $742.21 | |
| 99406 | <1% | 194 | $699.88 | |
| 99336 | <1% | 429 | $676.52 | |
| 20552 | <1% | 30 | $517.35 | |
| 96120 | <1% | 40 | $140.42 | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 43 | $87.92 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | <1% | 37,283 | $78.66 |
| 99347 | <1% | 14 | $0.21 | |
| 0518F | 0% | 194 | $0.00 | |
| 1090F | 0% | 14 | $0.00 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 325 | $0.00 |
| G9622 | Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method | 0% | 91 | $0.00 |
| 1100F | 0% | 258 | $0.00 | |
| G8482 | Influenza immunization administered or previously received | 0% | 175 | $0.00 |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 20 | $0.00 |
| 3288F | 0% | 109 | $0.00 | |
| 1101F | 0% | 1,807 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 100 | $0.00 |
| 1123F | 0% | 729 | $0.00 | |
| G9922 | Safety concerns screen provided and if positive then documented mitigation recommendations | 0% | 32 | $0.00 |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 24 | $0.00 |
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 officialMCCLAIN, BRIAN (CEO)
| Provider | Location | Paid |
|---|---|---|
| Lexington Surgery Center LTD | Lexington, KY | $5.41M |
| Skill Doc 101, LLC | Canton, OH | $436K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.