Physician
Pinnacle Health Medical Services
Pinnacle Health Medical Services was paid $14.03M by Medicaid between Jan 2018 and Nov 2024, across 160 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 37% of everything it billed.
33Billing provider infoPINNACLE HEALTH MEDICAL SERVICES
HARRISBURG, PA 17104
HARRISBURG, PA 17104
33aNPI1932143427assigned 06/15/2006
33bProvider typePediatrics Physician
28Total paid$14.03M
24GClaims320,921
24DCodes billed160
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Pediatrics Physician providers in Pennsylvania
Rank by total paid#3 of 1,257
Median peer was paid$45K
This provider vs. median309×
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 | 1,999 | $120K | |
| 2019 | 3,529 | $212K | |
| 2020 | 16,984 | $742K | |
| 2021 | 126,770 | $5.72M | |
| 2022 | 131,488 | $5.31M | |
| 2023 | 36,598 | $1.64M | |
| 2024incomplete | 3,553 | $287K |
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 | 37% | 82,952 | 78,027 | $5.19M |
| 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% | 76,276 | 70,823 | $3.43M |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | 3.4% | 5,491 | 5,179 | $472K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 3.0% | 8,990 | 2,819 | $421K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 2.9% | 4,430 | 4,395 | $401K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2.2% | 3,521 | 3,324 | $307K |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | 2.1% | 1,447 | 1,428 | $302K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.1% | 7,409 | 6,884 | $302K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.1% | 3,184 | 3,109 | $296K |
| 76819 | Fetal biophysical profile; without non-stress testing | 2.1% | 3,023 | 2,245 | $289K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.7% | 3,552 | 3,488 | $243K |
| 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 | 1.0% | 1,431 | 1,401 | $146K |
148 more codes
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.0% | 1,507 | $146K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | <1% | 1,248 | $121K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 759 | $112K |
| 99254 | <1% | 1,646 | $101K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 2,593 | $101K |
| 80305 | <1% | 6,408 | $84K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 1,954 | $75K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 797 | $71K |
| T1016 | Case management, each 15 minutes | <1% | 512 | $70K |
| J7307 | Etonogestrel (contraceptive) implant system, including implant and supplies | <1% | 127 | $65K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 405 | $61K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 5,223 | $61K |
| 95886 | <1% | 623 | $56K | |
| 99205 | Prolong outpt/office vis | <1% | 326 | $47K |
| 90715 | <1% | 3,249 | $45K | |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 495 | $44K |
| 76818 | <1% | 344 | $43K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 848 | $38K |
| 76820 | <1% | 740 | $35K | |
| 90682 | <1% | 1,955 | $32K | |
| 20610 | <1% | 1,128 | $32K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 631 | $31K |
| 90837 | Psychotherapy session, about an hour | <1% | 246 | $31K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 3,584 | $28K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 827 | $27K |
| 92551 | <1% | 7,116 | $26K | |
| T1001 | Nursing assessment / evaluation | <1% | 154 | $26K |
| 90670 | <1% | 3,208 | $24K | |
| 87428 | <1% | 2,186 | $23K | |
| 90651 | <1% | 1,959 | $22K | |
| 99243 | <1% | 233 | $22K | |
| 99173 | <1% | 6,211 | $21K | |
| 90686 | <1% | 1,823 | $20K | |
| 90674 | <1% | 3,958 | $19K | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 220 | $18K |
| 90732 | <1% | 396 | $17K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 160 | $16K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 581 | $15K |
| 90461 | <1% | 546 | $14K | |
| 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | <1% | 253 | $14K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 2,909 | $13K |
| 99381 | <1% | 153 | $13K | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 137 | $12K |
| J7298 | Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg | <1% | 28 | $12K |
| 90648 | <1% | 1,888 | $11K | |
| 0011A | <1% | 389 | $11K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,664 | $11K |
| 90734 | <1% | 1,494 | $11K | |
| 99460 | <1% | 237 | $10K | |
| 59025 | Fetal non-stress test | <1% | 433 | $9K |
| 81025 | <1% | 1,873 | $9K | |
| 90723 | <1% | 1,470 | $9K | |
| 90633 | <1% | 1,860 | $9K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 403 | $9K |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | <1% | 234 | $9K |
| 81003 | <1% | 2,229 | $8K | |
| 99051 | <1% | 344 | $7K | |
| 96161 | <1% | 3,141 | $7K | |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 141 | $7K |
| 99349 | <1% | 174 | $7K | |
| 95251 | <1% | 193 | $6K | |
| 90698 | <1% | 1,107 | $6K | |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | <1% | 620 | $6K |
| 99255 | <1% | 83 | $6K | |
| 90681 | <1% | 919 | $6K | |
| T1028 | Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs | <1% | 181 | $6K |
| 99284 | Emergency room visit (serious) | <1% | 128 | $5K |
| 99285 | Emergency room visit (most serious) | <1% | 114 | $5K |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | <1% | 75 | $5K |
| 59430 | <1% | 82 | $5K | |
| 31231 | <1% | 73 | $5K | |
| 90710 | <1% | 1,031 | $5K | |
| 99242 | <1% | 74 | $5K | |
| 90696 | <1% | 914 | $5K | |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 63 | $5K |
| 99245 | <1% | 26 | $5K | |
| 90716 | <1% | 774 | $4K | |
| 97597 | <1% | 124 | $4K | |
| 90707 | <1% | 779 | $4K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 3,810 | $4K |
| 87210 | <1% | 599 | $4K | |
| 0012A | <1% | 110 | $4K | |
| 90746 | <1% | 86 | $4K | |
| 90744 | <1% | 691 | $4K | |
| 90680 | <1% | 697 | $4K | |
| 96160 | <1% | 2,273 | $4K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 146 | $4K |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 1,111 | $4K |
| 95819 | <1% | 144 | $3K | |
| 90700 | <1% | 607 | $3K | |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 28 | $3K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 41 | $3K |
| 86580 | <1% | 1,148 | $3K | |
| 96127 | <1% | 1,441 | $3K | |
| 99188 | <1% | 140 | $3K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 164 | $3K |
| 64615 | <1% | 24 | $2K | |
| 90750 | <1% | 89 | $2K | |
| 11721 | <1% | 115 | $2K | |
| 99462 | <1% | 72 | $1K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 39 | $1K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 178 | $1K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 198 | $1K |
| 85018 | <1% | 641 | $1K | |
| 0013A | <1% | 37 | $1K | |
| 99348 | <1% | 87 | $1K | |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 12 | $980.39 |
| 99253 | <1% | 29 | $972.15 | |
| 96040 | <1% | 431 | $928.98 | |
| G0426 | Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth | <1% | 29 | $922.10 |
| 41010 | <1% | 12 | $848.07 | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 55 | $832.34 |
| 0001A | <1% | 30 | $821.60 | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 204 | $670.27 |
| 99385 | <1% | 15 | $608.36 | |
| 73564 | <1% | 15 | $577.59 | |
| 36416 | <1% | 940 | $562.27 | |
| 73630 | <1% | 23 | $466.80 | |
| 90714 | <1% | 25 | $440.14 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 845 | $410.27 |
| 97802 | <1% | 18 | $369.05 | |
| S0020 | Injection, bupivicaine hydrochloride, 30 ml | <1% | 204 | $361.57 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 789 | $357.71 |
| 88720 | <1% | 48 | $317.02 | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 49 | $307.85 |
| 94010 | <1% | 26 | $291.04 | |
| 73100 | <1% | 14 | $278.97 | |
| 0002A | <1% | 15 | $240.00 | |
| 99050 | <1% | 18 | $230.30 | |
| 93000 | <1% | 15 | $225.76 | |
| 83655 | <1% | 2,242 | $221.00 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 518 | $171.34 |
| 94729 | <1% | 26 | $167.62 | |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 15 | $165.52 |
| 94727 | <1% | 15 | $156.56 | |
| 94726 | <1% | 13 | $140.90 | |
| 94060 | <1% | 15 | $120.46 | |
| 80061 | Lipid panel | <1% | 807 | $109.20 |
| 82962 | <1% | 51 | $107.40 | |
| 90620 | <1% | 13 | $79.00 | |
| J7620 | Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme | <1% | 188 | $2.14 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | 0% | 80 | $0.00 |
| 90619 | 0% | 190 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 97 | $0.00 |
| 90677 | 0% | 217 | $0.00 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 0% | 369 | $0.00 |
| G9919 | Screening performed and positive and provision of recommendations | 0% | 26 | $0.00 |
| G0427 | Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth | 0% | 16 | $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 officialLINEBAUGH, SHERRI (SR PROV ENROLL COORD)
| Provider | Location | Paid |
|---|---|---|
| Pinnacle Health Medical Services | Mechanicsburg, PA | $140K |
| Pinnacle Health Medical Services | Shrewsbury, PA | $18K |
| Pinnacle Health Medical Services | Chambersburg, PA | $14K |
| Pinnacle Health Medical Services | Camp Hill, PA | $7K |
| Pinnacle Health Medical Services | Gettysburg, PA | $656.87 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.