Physician
Einstein Practice Plan INC
Einstein Practice Plan INC was paid $1.89M by Medicaid between May 2018 and Dec 2024, across 26 billing codes. Its largest line is 99291, Critical care, evaluation and management of the critically ill patient, first 30-74 minutes — 79% of everything it billed.
33Billing provider infoEINSTEIN PRACTICE PLAN INC
PHILADELPHIA, PA 19141
PHILADELPHIA, PA 19141
33aNPI1245297605assigned 04/28/2006
33bProvider typePulmonary Disease Physician
28Total paid$1.89M
24GClaims20,521
24DCodes billed26
24AFirst – last monthMay 2018 – Dec 2024
Compared with peers
Next to other Pulmonary Disease Physician providers in Pennsylvania
Rank by total paid#1 of 137
Median peer was paid$7K
This provider vs. median264×
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 | 126 | $306.96 | |
| 2020 | 774 | $60K | |
| 2021 | 4,320 | $324K | |
| 2022 | 4,601 | $444K | |
| 2023 | 5,697 | $575K | |
| 2024incomplete | 5,003 | $484K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 79% | 10,226 | 3,369 | $1.49M |
| 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 | 5.7% | 2,221 | 2,146 | $108K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | 5.0% | 827 | 803 | $94K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 3.5% | 1,523 | 731 | $67K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.3% | 1,279 | 1,248 | $44K |
| 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 | 1.1% | 226 | 215 | $20K |
| 94060 | <1% | 1,216 | 1,172 | $10K | |
| 94726 | <1% | 931 | 885 | $9K | |
| 99254 | <1% | 94 | 90 | $7K | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 125 | 120 | $7K |
| 94729 | <1% | 901 | 856 | $6K | |
| 94618 | <1% | 266 | 260 | $5K |
14 more codes
| 99255 | <1% | 67 | $4K | |
| 99407 | <1% | 206 | $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 | <1% | 17 | $3K |
| 99205 | Prolong outpt/office vis | <1% | 26 | $2K |
| 31624 | <1% | 25 | $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) | <1% | 99 | $923.88 |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 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) | <1% | 37 | $460.00 |
| 76604 | <1% | 12 | $350.01 | |
| 3079F | <1% | 16 | $0.06 | |
| 3074F | <1% | 14 | $0.05 | |
| 3078F | <1% | 13 | $0.04 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 0% | 127 | $0.00 |
| 99232 | Hospital visit by a doctor, follow-up day | 0% | 14 | $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-EINSTEIN PRACTICE PLAN INC)
| Provider | Location | 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 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.