Clinic
Primary Health Network
Primary Health Network was paid $5.05M by Medicaid between Jan 2019 and Dec 2024, across 32 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 100% of everything it billed.
33Billing provider infoPRIMARY HEALTH NETWORK
LEWISTOWN, PA 17044
LEWISTOWN, PA 17044
33aNPI1043704513assigned 06/19/2018
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$5.05M
24GClaims53,882
24DCodes billed32
24AFirst – last monthJan 2019 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Pennsylvania
Rank by total paid#53 of 240
Median peer was paid$909K
This provider vs. median5.6×
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 SIZER, CARL controls 20+ related entities in our dataset. Read more
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 | |
|---|---|---|---|
| 2019 | 5,806 | $523K | |
| 2020 | 3,036 | $295K | |
| 2021 | 11,685 | $817K | |
| 2022 | 8,725 | $863K | |
| 2023 | 13,615 | $1.34M | |
| 2024incomplete | 11,015 | $1.20M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 100% | 22,060 | 19,594 | $5.04M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 1,526 | 1,255 | $4K |
| 0012A | <1% | 52 | 52 | $2K | |
| 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 | <1% | 423 | 404 | $2K |
| 0011A | <1% | 47 | 47 | $2K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 217 | 183 | $241.97 |
| D1110 | Prophylaxis - adult | <1% | 4,411 | 4,400 | $36.00 |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 0% | 985 | 874 | $0.00 |
| D0330 | Panoramic radiographic image | 0% | 1,050 | 1,049 | $0.00 |
| D0220 | Intraoral - periapical first radiographic image | 0% | 2,313 | 2,279 | $0.00 |
| D1120 | Dental cleaning, childProphylaxis - child | 0% | 1,050 | 1,049 | $0.00 |
| D0274 | Bitewings - four radiographic images | 0% | 3,961 | 3,953 | $0.00 |
20 more codes
| D2150 | Silver amalgam - two surfaces, primary or permanent | 0% | 119 | $0.00 |
| D2140 | 0% | 53 | $0.00 | |
| D0272 | Bitewings - two radiographic images | 0% | 510 | $0.00 |
| 3008F | 0% | 926 | $0.00 | |
| D1206 | Topical application of fluoride varnish | 0% | 2,080 | $0.00 |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 0% | 246 | $0.00 |
| D7140 | Extraction, erupted tooth or exposed root | 0% | 285 | $0.00 |
| D2330 | 0% | 65 | $0.00 | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 0% | 1,126 | $0.00 |
| D9995 | 0% | 57 | $0.00 | |
| D0140 | Limited oral evaluation - problem focused | 0% | 1,741 | $0.00 |
| D0120 | Dental checkup, returning patient | 0% | 6,615 | $0.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | 0% | 381 | $0.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 0% | 404 | $0.00 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 253 | $0.00 |
| D1351 | Sealant - per tooth | 0% | 647 | $0.00 |
| D0603 | 0% | 45 | $0.00 | |
| D2331 | 0% | 116 | $0.00 | |
| 91301 | 0% | 105 | $0.00 | |
| D2335 | 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.
From NPPES
Who's on the registration
Authorized officialSIZER, CARL (CHIEF FINANCIAL OFFICER)
| Provider | Location | 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 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.