Pinnacle Health Medical Services
Pinnacle Health Medical Services was paid $343K by Medicaid between Jan 2023 and Dec 2024, across 23 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 66% of everything it billed.
HARRISBURG, PA 17110
Next to other 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 | |
|---|---|---|---|
| 2023 | 4,608 | $182K | |
| 2024incomplete | 4,094 | $161K |
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 | 66% | 4,696 | 4,120 | $225K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 7.4% | 366 | 296 | $25K |
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | 6.4% | 16 | 16 | $22K |
| 99222 | Initial hospital care, per day, moderate complexity | 4.4% | 131 | 121 | $15K |
| 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 | 3.9% | 209 | 197 | $13K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 3.1% | 690 | 680 | $11K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 3.1% | 320 | 305 | $11K |
| 99238 | Hospital discharge day management, 30 minutes or less | 2.5% | 126 | 122 | $8K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | 1.5% | 107 | 98 | $5K |
| 81025 | <1% | 463 | 453 | $2K | |
| 87210 | <1% | 202 | 193 | $1K | |
| 54150 | <1% | 13 | 13 | $1K |
11 more codes
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 46 | $1K |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | <1% | 103 | $763.89 |
| 36415 | Collection of venous blood by venipuncture | <1% | 943 | $489.09 |
| 0502F | <1% | 39 | $390.00 | |
| 96127 | <1% | 52 | $263.10 | |
| 81003 | <1% | 14 | $44.64 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 13 | $0.00 |
| 90674 | 0% | 30 | $0.00 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 0% | 14 | $0.00 |
| 90715 | 0% | 96 | $0.00 | |
| 90661 | 0% | 13 | $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.
Who's on the registration
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.