UPMC Pinnacle Hospitals
UPMC Pinnacle Hospitals was paid $10K by Medicaid between Dec 2019 and Aug 2023, across 15 billing codes. Its largest line is 99284, emergency room visit (serious) — 73% of everything it billed.
MECHANICSBURG, PA 17050
Next to other General Acute Care Hospital 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 | |
|---|---|---|---|
| 2019 | 72 | $2K | |
| 2020 | 161 | $6K | |
| 2021 | 531 | $2K | |
| 2022 | 705 | $0.00 | |
| 2023 | 427 | $0.00 |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 73% | 106 | 95 | $7K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 11% | 19 | 18 | $1K |
| 96375 | Therapeutic injection; each additional sequential IV push | 5.9% | 43 | 25 | $569.60 |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 3.5% | 83 | 68 | $338.34 |
| J2704 | Injection, propofol, 10 mg | 2.1% | 390 | 341 | $197.51 |
| 80053 | Comprehensive metabolic panel | 1.3% | 16 | 12 | $128.59 |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 422 | 314 | $77.06 |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 12 | 12 | $65.52 |
| 85027 | <1% | 12 | 12 | $49.62 | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 12 | 12 | $29.25 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 174 | 172 | $21.48 |
| J3490 | Unclassified drugs | <1% | 99 | 97 | $15.94 |
3 more codes
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 |
|---|---|---|
| UPMC Hillman Cancer Center-Pinnacle | Camp Hill, PA | $246K |
| Pinnacle Health Medical Services | Lemoyne, PA | $156K |
| Pinnacle Health Medical Services | Lemoyne, PA | $38K |
| Pinnacle Health Medical Services | Harrisburg, PA | $38K |
| Pinnacle Health Regional Physicians | Lancaster, PA | $20K |
| Pinnacle Health Medical Services | Lemoyne, PA | $12K |
| UPMC Pinnacle Hospitals | Harrisburg, PA | $8K |
| Pinnacle Health Medical Services | Lemoyne, PA | $7K |
| Pinnacle Health Medical Services | Enola, PA | $3K |
| UPMC Pinnacle Hospitals | Harrisburg, PA | $2K |
| Pinnacle Health Medical Services | Hummelstown, PA | $2K |
| Pinnacle Health Medical Services | Lemoyne, PA | $2K |
| UPMC Pinnacle Hospitals | Mechanicsburg, PA | $1K |
| Pinnacle Health Medical Services | Lancaster, PA | $1K |
| Pinnacle Health Medical Services | York, PA | $510.10 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.