Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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PRIMARY HEALTH NETWORK

NPI: 1043704513 · LEWISTOWN, PA 17044 · Federally Qualified Health Center (FQHC) · NPI assigned 06/19/2018

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official SIZER, CARL controls 20+ related entities in our dataset. Read more

$5.05M
Total Medicaid Paid
53,882
Total Claims
49,977
Beneficiaries
32
Codes Billed
2019-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialSIZER, CARL (CHIEF FINANCIAL OFFICER)
NPI Enumeration Date06/19/2018

Related Entities

Other providers sharing the same authorized official: SIZER, CARL

ProviderCityStateTotal Paid
PRIMARY HEALTH NETWORK SHARON PA $57.95M
PRIMARY HEALTH NETWORK ALTOONA PA $19.65M
PRIMARY HEALTH NETWORK MERCER PA $12.27M
PRIMARY HEALTH NETWORK FARRELL PA $5.60M
PRIMARY HEALTH NETWORK CLARION PA $3.53M
PRIMARY HEALTH NETWORK SHARON PA $3.47M
PRIMARY HEALTH NETWORK NEW CASTLE PA $3.21M
PRIMARY HEALTH NETWORK SHARON PA $2.51M
PRIMARY HEALTH NETWORK GREENVILLE PA $2.39M
PRIMARY HEALTH NETWORK INDIANA PA $1.94M
PRIMARY HEALTH NETWORK NEW CASTLE PA $1.84M
PRIMARY HEALTH NETWORK ROCHESTER PA $1.66M
PRIMARY HEALTH NETWORK SHEAKLEYVILLE PA $1.65M
PRIMARY HEALTH NETWORK WARREN PA $1.28M
PRIMARY HEALTH NETWORK MINERSVILLE PA $1.24M
PRIMARY HEALTH NETWORK SHAMOKIN PA $1.19M
PRIMARY HEALTH NETWORK BEAVER FALLS PA $1.02M
PRIMARY HEALTH NETWORK LATROBE PA $914K
PRIMARY HEALTH NETWORK FARRELL PA $622K
PRIMARY HEALTH NETWORK ERIE PA $546K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2019 5,806 $523K
2020 3,036 $295K
2021 11,685 $817K
2022 8,725 $863K
2023 13,615 $1.34M
2024 11,015 $1.20M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 22,060 19,594 $5.04M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 1,526 1,255 $4K
0012A 52 52 $2K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 423 404 $2K
0011A 47 47 $2K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 217 183 $241.97
D1110 Prophylaxis - adult 4,411 4,400 $36.00
D2391 Resin-based composite - one surface, posterior, primary or permanent 985 874 $0.00
D0330 Panoramic radiographic image 1,050 1,049 $0.00
D0220 Intraoral - periapical first radiographic image 2,313 2,279 $0.00
D1120 Prophylaxis - child 1,050 1,049 $0.00
D0274 Bitewings - four radiographic images 3,961 3,953 $0.00
D2150 Silver amalgam - two surfaces, primary or permanent 119 103 $0.00
D2140 53 44 $0.00
D0272 Bitewings - two radiographic images 510 508 $0.00
3008F 926 841 $0.00
D1206 Topical application of fluoride varnish 2,080 2,077 $0.00
D2393 Resin-based composite - three surfaces, posterior, primary or permanent 246 239 $0.00
D7140 Extraction, erupted tooth or exposed root 285 220 $0.00
D2330 65 52 $0.00
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 1,126 1,034 $0.00
D9995 57 56 $0.00
D0140 Limited oral evaluation - problem focused 1,741 1,683 $0.00
D0120 Periodic oral evaluation - established patient 6,615 6,599 $0.00
D0150 Comprehensive oral evaluation - new or established patient 381 381 $0.00
D0230 Intraoral - periapical each additional radiographic image 404 380 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 253 238 $0.00
D1351 Sealant - per tooth 647 125 $0.00
D0603 45 45 $0.00
D2331 116 100 $0.00
91301 105 101 $0.00
D2335 13 12 $0.00