Medicaid Provider Spending

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

NPI: 1164831657 · ROCHESTER, PA 15074 · Federally Qualified Health Center (FQHC) · NPI assigned 08/08/2014

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

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

$1.66M
Total Medicaid Paid
16,003
Total Claims
14,362
Beneficiaries
18
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialSIZER, CARL (CHIEF FINANCIAL OFFICER)
NPI Enumeration Date08/08/2014

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 NEW CASTLE PA $3.21M
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 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 298 $33K
2019 2,713 $238K
2020 2,826 $190K
2021 3,929 $313K
2022 1,135 $157K
2023 2,462 $350K
2024 2,640 $379K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 8,245 7,023 $1.66M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 202 173 $260.15
D1110 Prophylaxis - adult 1,289 1,282 $65.22
D0274 Bitewings - four radiographic images 1,210 1,195 $39.30
D0120 Periodic oral evaluation - established patient 1,230 1,215 $33.56
D0220 Intraoral - periapical first radiographic image 944 926 $9.83
D0140 Limited oral evaluation - problem focused 583 551 $0.00
D0150 Comprehensive oral evaluation - new or established patient 408 405 $0.00
G2025 Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only 338 191 $0.00
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 95 71 $0.00
D1206 Topical application of fluoride varnish 40 39 $0.00
G0467 Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit 286 232 $0.00
D9995 240 237 $0.00
D0230 Intraoral - periapical each additional radiographic image 188 142 $0.00
D2393 Resin-based composite - three surfaces, posterior, primary or permanent 26 20 $0.00
D5899 20 16 $0.00
D0330 Panoramic radiographic image 629 620 $0.00
D2391 Resin-based composite - one surface, posterior, primary or permanent 30 24 $0.00