Primary Health Network

Primary Health Network was paid $3.21M by Medicaid between Jan 2018 and Dec 2024, across 17 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
NEW CASTLE, PA 16105

33aNPI1114256146assigned 12/22/2009

33bProvider typeFederally Qualified Health Center (FQHC)

28Total paid$3.21M

24GClaims31,555

24DCodes billed17

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Federally Qualified Health Center (FQHC) providers in Pennsylvania

Rank by total paid#67 of 240

Median peer was paid$909K

This provider vs. median3.5×

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
2018	1,984	$174K
2019	8,584	$715K
2020	2,896	$241K
2021	4,306	$311K
2022	3,007	$429K
2023	7,367	$901K
2024incomplete	3,411	$439K

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%	15,931	11,049	$3.21M
D0140	Limited oral evaluation - problem focused	<1%	1,053	886	$373.36
D0330	Panoramic radiographic image	<1%	1,032	996	$177.04
D5899		<1%	300	198	$137.68
D1110	Prophylaxis - adult	<1%	3,224	2,571	$68.26
D0274	Bitewings - four radiographic images	<1%	1,971	1,615	$60.00
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	<1%	4,217	3,340	$51.24
D0220	Intraoral - periapical first radiographic image	<1%	1,316	1,191	$24.66
D1120	Dental cleaning, childProphylaxis - child	0%	97	97	$0.00
D2391	Resin-based composite - one surface, posterior, primary or permanent	0%	106	86	$0.00
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	0%	220	192	$0.00
D0150	Comprehensive oral evaluation - new or established patient	0%	625	592	$0.00

5 more codes

D0272	Bitewings - two radiographic images	0%	837	$0.00
D9995		0%	156	$0.00
D1206	Topical application of fluoride varnish	0%	339	$0.00
D0230	Intraoral - periapical each additional radiographic image	0%	92	$0.00
D0603		0%	39	$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)

Same official

Other billing entities under SIZER, CARL

Full network →

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	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

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