Medicaid Provider Spending

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

EINSTEIN PRACTICE PLAN INC

NPI: 1245297605 · PHILADELPHIA, PA 19141 · Pulmonary Disease Physician · NPI assigned 04/28/2006

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

Authorized official BARGERON, FRANCINE controls 17+ related entities in our dataset. Read more

$1.89M
Total Medicaid Paid
20,521
Total Claims
12,546
Beneficiaries
26
Codes Billed
2018-05
First Month
2024-12
Last Month

Provider Details

Authorized OfficialBARGERON, FRANCINE (DIRECTOR-EINSTEIN PRACTICE PLAN INC)
NPI Enumeration Date04/28/2006

Related Entities

Other providers sharing the same authorized official: BARGERON, FRANCINE

ProviderCityStateTotal Paid
EINSTEIN PRACTICE PLAN, INC PHILADELPHIA PA $11.46M
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 $1.73M
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

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 126 $306.96
2020 774 $60K
2021 4,320 $324K
2022 4,601 $444K
2023 5,697 $575K
2024 5,003 $484K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 10,226 3,369 $1.49M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 2,221 2,146 $108K
99244 Office or other outpatient consultation, moderate to high complexity 827 803 $94K
99233 Prolong inpt eval add15 m 1,523 731 $67K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 1,279 1,248 $44K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 226 215 $20K
94060 1,216 1,172 $10K
94726 931 885 $9K
99254 94 90 $7K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 125 120 $7K
94729 901 856 $6K
94618 266 260 $5K
99255 67 66 $4K
99407 206 191 $4K
G0399 Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation 17 16 $3K
99205 Prolong outpt/office vis 26 24 $2K
31624 25 24 $1K
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) 99 96 $923.88
99215 Prolong outpt/office vis 13 13 $729.56
G0296 Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) 37 37 $460.00
76604 12 12 $350.01
3079F 16 13 $0.06
3074F 14 14 $0.05
3078F 13 13 $0.04
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 127 120 $0.00
99232 Subsequent hospital care, per day, moderate complexity 14 12 $0.00