Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Physician

Einstein Practice Plan, INC.

Einstein Practice Plan, INC. was paid $774K by Medicaid between Oct 2020 and Dec 2024, across 14 billing codes. Its largest line is 66984, Extracapsular cataract removal with insertion of intraocular lens prosthesis — 35% of everything it billed.

33Billing provider infoEINSTEIN PRACTICE PLAN, INC.
PHILADELPHIA, PA 19141
33aNPI1154419166assigned 10/11/2006
33bProvider typeOphthalmology Physician
28Total paid$774K
24GClaims11,455
24DCodes billed14
24AFirst – last monthOct 2020 – Dec 2024
Compared with peers

Next to other Ophthalmology Physician providers in Pennsylvania

Rank by total paid#11 of 288
Median peer was paid$7K
This provider vs. median111×

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

$0$10K$20K$30K2018201920202021202220232024
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
YearClaimsPaid
2020309$13K
20212,349$117K
20222,931$192K
20233,111$234K
2024incomplete2,755$219K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis 35% 588 573 $274K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 27% 3,337 3,265 $212K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 13% 2,396 2,319 $101K
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient 7.1% 2,038 1,896 $55K
99204 Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 5.5% 427 422 $42K
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 5.3% 827 802 $41K
92083 2.7% 452 440 $21K
92133 1.8% 534 523 $14K
92228 <1% 343 330 $6K
92134 <1% 166 162 $4K
99254 <1% 24 24 $1K
76519 <1% 39 37 $875.02
2 more codes
92015 Determination of refractive state <1% 271 $660.07
99213 Doctor's office visit, returning patient (routine) <1% 13 $368.20

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)
Same official

Other billing entities under BARGERON, FRANCINE

Full network →
ProviderLocationPaid
Einstein Practice Plan, INCPhiladelphia, PA$11.46M
Einstein Practice Plan INCPhila, PA$8.02M
Einstein Practice Plan INCPhiladelphia, PA$4.26M
Einstein Practice Plan INCElkins Park, PA$2.02M
Einstein Practice Plan INCPhiladelphia, PA$1.89M
Einstein Practice Plan, INCPhiladelphia, PA$1.73M
Einstein Practice Plan INCPhiladelphia, PA$1.65M
Einstein Practice Plan INCPhiladelphia, PA$1.40M
Einstein Practice Plan INCPhiladelphia, PA$1.23M
Einstein Practice Plan, INCPhiladelphia, PA$977K
Einstein Practice Plan, INC.Philadelphia, PA$926K
Einstein Practice Plan INCPhiladelphia, PA$636K
Einstein Practice Plan INCPhiladelphia, PA$551K
Einstein Practice Plan INCPhiladelphia, PA$400K
Einstein Practice Plan INCElkins Park, PA$170K
Einstein Practice Plan INCPhiladelphia, PA$15K
Einstein Practice Plan INCPhiladelphia, PA$4K

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