Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Physician

Prospect Health Access Network, INC.

Prospect Health Access Network, INC. was paid $43K by Medicaid between May 2018 and Apr 2023, across 6 billing codes. Its largest line is G2012, Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion — 73% of everything it billed.

33Billing provider infoPROSPECT HEALTH ACCESS NETWORK, INC.
CHESTER, PA 19013
33aNPI1013364520assigned 05/16/2016
33bProvider typeNeurology Physician
28Total paid$43K
24GClaims1,821
24DCodes billed6
24AFirst – last monthMay 2018 – Apr 2023
Compared with peers

Next to other Neurology Physician providers in Pennsylvania

Rank by total paid#31 of 165
Median peer was paid$5K
This provider vs. median7.9×

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.

Entity ProliferationAuthorized official ELDERS, ROBERT controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$1.0K$2.0K$3.0K2018201920202021202220232024
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
201826$93.45
2020172$5K
2021837$20K
2022575$12K
2023211$5K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion 73% 1,615 1,588 $31K
95810 Polysomnography; sleep staging with 4 or more additional parameters 14% 67 67 $6K
99203 Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity 7.9% 55 54 $3K
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 2.2% 44 43 $963.44
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 1.4% 12 12 $597.86
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 1.3% 28 27 $571.67

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 officialELDERS, ROBERT (SECRETARY)
Same official

Other billing entities under ELDERS, ROBERT

Full network →
ProviderLocationPaid
Prospect Waterbury, INC.Waterbury, CT$84.62M
Prospect Manchester Hospital, INC.Manchester, CT$69.20M
Prospect Chartercare RWMC, LLCProvidence, RI$57.10M
Prospect CCMC, LLCChester, PA$40.89M
Prospect CT Medical Foundation, INC.Manchester, CT$34.07M
Prospect Rockville Hospital, INC.Vernon, CT$30.06M
Prospect Chartercare Sjhsri, LLCNorth Providence, RI$10.94M
Prospect DCMH, LLCDrexel Hill, PA$10.37M
Prospect CCMC, LLCChester, PA$5.46M
Alta Los Angeles Hospitals, INC.Los Angeles, CA$5.42M
Prospect CCMC, LLCChester, PA$5.03M
Prospect CCMC, LLCChester, PA$3.71M
Prospect Chartercare Physicians, LLCCranston, RI$2.31M
Prospect Echn Home Health, INC.Vernon, CT$1.75M
Prospect Waterbury Home Health, INC.Watertown, CT$1.30M
Prospect Health Access Network, INC.Chester, PA$1.22M
Alta Newport Hospital, LLCTustin, CA$1.16M
Prospect Health Access Network, INC.Crum Lynne, PA$924K
Prospect Health Access Network, INC.Chester, PA$872K
Prospect Chartercare Sjhsri, LLCNorth Providence, RI$858K

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.