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

Einstein Practice Plan,inc

Einstein Practice Plan,inc was paid $322K by Medicaid between Jan 2018 and Dec 2024, across 13 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 32% of everything it billed.

33Billing provider infoEINSTEIN PRACTICE PLAN,INC
PHILADELPHIA, PA 19141
33aNPI1154760809assigned 06/17/2013
33bProvider typeUrology Physician
28Total paid$322K
24GClaims7,226
24DCodes billed13
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Urology Physician providers in Pennsylvania

Rank by total paid#11 of 134
Median peer was paid$3K
This provider vs. median102×

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 JACKSON, MARY controls 13+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$10K$20K2018201920202021202220232024
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
201847$488.88
2020159$6K
2021939$37K
20221,383$60K
20232,355$125K
2024incomplete2,343$94K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
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 32% 2,586 2,483 $103K
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 22% 2,034 1,975 $70K
99244 Office or other outpatient consultation, moderate to high complexity 18% 463 439 $59K
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 11% 365 357 $34K
99243 6.9% 293 291 $22K
99203 Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity 4.5% 248 242 $14K
51798 1.9% 458 434 $6K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 1.5% 226 222 $5K
99242 <1% 85 85 $3K
99245 <1% 14 13 $2K
99215 Doctor's office visit, returning patient (complex)Prolong outpt/office vis <1% 29 28 $2K
99205 Prolong outpt/office vis <1% 17 13 $1K
1 more codes
81002 <1% 408 $549.21

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 officialJACKSON, MARY (DIRECTOR)
Same official

Other billing entities under JACKSON, MARY

Full network →
ProviderLocationPaid
Einstein Practice Plan INCPhiladelphia, PA$13.85M
Always on Time Homecare LLCLuthersville, GA$8.22M
Einstein Practice Plan INCPhiladelphia, PA$2.98M
Einstein Practice Plan INCPhiladelphia, PA$2.46M
Einstein Practice Plan INCPhiladelphia, PA$1.99M
Geriatric Care SolutionsSaint Charles, MO$1.52M
Abbeville County Memorial HospitalAbbeville, SC$1.46M
Einstein Practice Plan INCPhila, PA$1.05M
Einstein Practice Plan, INC.Philadelphia, PA$682K
Einstein Practice Plan INCPhila, PA$624K
Abbeville County Memorial HospitalDue West, SC$364K
Einstein Practice Plan INCPhiladelphia, PA$38K
Einstein Practice Plan INCPhiladelphia, PA$4K

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