Medicaid Provider Spending

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

NPI: 1114256146 · NEW CASTLE, PA 16105 · Federally Qualified Health Center (FQHC) · NPI assigned 12/22/2009

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

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

$3.21M
Total Medicaid Paid
31,555
Total Claims
24,230
Beneficiaries
17
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialSIZER, CARL (CHIEF FINANCIAL OFFICER)
NPI Enumeration Date12/22/2009

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 LEWISTOWN PA $5.05M
PRIMARY HEALTH NETWORK CLARION PA $3.53M
PRIMARY HEALTH NETWORK SHARON PA $3.47M
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
2018 1,984 $174K
2019 8,584 $715K
2020 2,896 $241K
2021 4,306 $311K
2022 3,007 $429K
2023 7,367 $901K
2024 3,411 $439K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 15,931 11,049 $3.21M
D0140 Limited oral evaluation - problem focused 1,053 886 $373.36
D0330 Panoramic radiographic image 1,032 996 $177.04
D5899 300 198 $137.68
D1110 Prophylaxis - adult 3,224 2,571 $68.26
D0274 Bitewings - four radiographic images 1,971 1,615 $60.00
D0120 Periodic oral evaluation - established patient 4,217 3,340 $51.24
D0220 Intraoral - periapical first radiographic image 1,316 1,191 $24.66
D1120 Prophylaxis - child 97 97 $0.00
D2391 Resin-based composite - one surface, posterior, primary or permanent 106 86 $0.00
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 220 192 $0.00
D0150 Comprehensive oral evaluation - new or established patient 625 592 $0.00
D0272 Bitewings - two radiographic images 837 812 $0.00
D9995 156 152 $0.00
D1206 Topical application of fluoride varnish 339 339 $0.00
D0230 Intraoral - periapical each additional radiographic image 92 75 $0.00
D0603 39 39 $0.00