Physician
Einstein Practice Plan, INC
Einstein Practice Plan, INC was paid $11.46M by Medicaid between Jan 2018 and Dec 2024, across 63 billing codes. Its largest line is 99215, doctor's office visit, returning patient (complex) — 22% of everything it billed.
33Billing provider infoEINSTEIN PRACTICE PLAN, INC
PHILADELPHIA, PA 19120
PHILADELPHIA, PA 19120
33aNPI1154355220assigned 07/11/2006
33bProvider typeMaternal & Fetal Medicine Physician
28Total paid$11.46M
24GClaims262,532
24DCodes billed63
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Maternal & Fetal Medicine Physician providers in Pennsylvania
Rank by total paid#1 of 60
Median peer was paid$37K
This provider vs. median314×
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 BARGERON, FRANCINE controls 17+ 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 | 739 | $38K | |
| 2019 | 336 | $15K | |
| 2020 | 17,128 | $678K | |
| 2021 | 76,517 | $3.32M | |
| 2022 | 67,523 | $2.94M | |
| 2023 | 51,463 | $2.39M | |
| 2024incomplete | 48,826 | $2.08M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 22% | 30,014 | 21,923 | $2.53M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 16% | 39,276 | 37,294 | $1.80M |
| 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 | 8.0% | 14,504 | 13,834 | $915K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | 6.8% | 15,159 | 13,806 | $784K |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | 6.0% | 5,086 | 4,949 | $689K |
| 76801 | 3.7% | 6,120 | 5,961 | $423K | |
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | 3.5% | 8,089 | 7,645 | $399K |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | 3.2% | 6,786 | 6,472 | $368K |
| 76813 | 2.7% | 4,987 | 4,880 | $314K | |
| 59025 | Fetal non-stress test | 2.1% | 13,330 | 9,557 | $243K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | 2.1% | 6,399 | 4,957 | $238K |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | 2.1% | 4,059 | 3,574 | $237K |
51 more codes
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | 2.0% | 145 | $231K |
| T1001 | Nursing assessment / evaluation | 2.0% | 1,869 | $224K |
| 76818 | 1.9% | 3,391 | $217K | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 1.6% | 3,881 | $182K |
| 76819 | Fetal biophysical profile; without non-stress testing | 1.5% | 3,996 | $177K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.5% | 4,868 | $176K |
| 59430 | <1% | 1,061 | $108K | |
| J7307 | Etonogestrel (contraceptive) implant system, including implant and supplies | <1% | 252 | $104K |
| 54150 | <1% | 895 | $90K | |
| 76820 | <1% | 2,595 | $86K | |
| 99429 | <1% | 626 | $84K | |
| 81025 | <1% | 15,578 | $80K | |
| 90651 | <1% | 1,311 | $71K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 4,022 | $62K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 1,347 | $61K |
| 36415 | Collection of venous blood by venipuncture | <1% | 14,985 | $57K |
| 99242 | <1% | 869 | $52K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 945 | $47K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 2,519 | $41K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 645 | $39K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 246 | $34K |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 635 | $33K |
| 0502F | <1% | 3,207 | $32K | |
| 81002 | <1% | 11,949 | $30K | |
| S9470 | Nutritional counseling, dietitian visit | <1% | 626 | $30K |
| 90715 | <1% | 2,416 | $27K | |
| 99243 | <1% | 266 | $24K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 215 | $24K |
| J7297 | Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg | <1% | 224 | $22K |
| 99241 | <1% | 486 | $19K | |
| 87210 | <1% | 4,407 | $19K | |
| 90686 | <1% | 998 | $7K | |
| 99205 | Prolong outpt/office vis | <1% | 152 | $6K |
| 11982 | <1% | 37 | $5K | |
| 76821 | <1% | 87 | $4K | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 101 | $4K |
| 58300 | <1% | 69 | $1K | |
| 97803 | <1% | 30 | $1K | |
| 99201 | <1% | 49 | $1K | |
| 99000 | <1% | 16,247 | $1K | |
| 99219 | <1% | 14 | $839.03 | |
| 99406 | <1% | 57 | $549.73 | |
| 58301 | <1% | 24 | $524.01 | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 24 | $481.00 |
| 76830 | Ultrasound, transvaginal | <1% | 13 | $463.77 |
| 76857 | <1% | 14 | $179.40 | |
| 99459 | <1% | 18 | $159.00 | |
| G9920 | Screening performed and negative | <1% | 226 | $1.01 |
| 90630 | 0% | 12 | $0.00 | |
| 90656 | 0% | 48 | $0.00 | |
| 90688 | 0% | 26 | $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 officialBARGERON, FRANCINE (DIRECTOR)
| Provider | Location | Paid |
|---|---|---|
| Einstein Practice Plan INC | Phila, PA | $8.02M |
| Einstein Practice Plan INC | Philadelphia, PA | $4.26M |
| Einstein Practice Plan INC | Elkins Park, PA | $2.02M |
| Einstein Practice Plan INC | Philadelphia, PA | $1.89M |
| Einstein Practice Plan, INC | Philadelphia, PA | $1.73M |
| Einstein Practice Plan INC | Philadelphia, PA | $1.65M |
| Einstein Practice Plan INC | Philadelphia, PA | $1.40M |
| Einstein Practice Plan INC | Philadelphia, PA | $1.23M |
| Einstein Practice Plan, INC | Philadelphia, PA | $977K |
| Einstein Practice Plan, INC. | Philadelphia, PA | $926K |
| Einstein Practice Plan, INC. | Philadelphia, PA | $774K |
| Einstein Practice Plan INC | Philadelphia, PA | $636K |
| Einstein Practice Plan INC | Philadelphia, PA | $551K |
| Einstein Practice Plan INC | Philadelphia, PA | $400K |
| Einstein Practice Plan INC | Elkins Park, PA | $170K |
| Einstein Practice Plan INC | Philadelphia, PA | $15K |
| Einstein Practice Plan INC | Philadelphia, PA | $4K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.