Einstein Practice Plan, INC.

Einstein Practice Plan, INC. was paid $4.32M by Medicaid between Jan 2018 and Dec 2024, across 55 billing codes. Its largest line is 99285, emergency room visit (most serious) — 65% of everything it billed.

33Billing provider infoEINSTEIN PRACTICE PLAN, INC.
PHILADELPHIA, PA 19141

33aNPI1316099898assigned 01/17/2007

33bProvider typeClinic/Center

28Total paid$4.32M

24GClaims21,524

24DCodes billed55

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Clinic/Center providers in Pennsylvania

Rank by total paid#36 of 176

Median peer was paid$441K

This provider vs. median9.8×

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.

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	3,284	$76K
2019	76	$2K
2020	224	$250.00
2021	4,939	$975K
2022	4,137	$1.04M
2023	3,651	$1.14M
2024incomplete	5,213	$1.08M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99285	Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life	65%	6,468	5,990	$2.79M
99253		12%	2,949	2,840	$521K
99282	Emergency department visit for the evaluation and management, low to moderate severity	6.2%	1,051	954	$269K
99284	Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity	5.8%	714	691	$250K
99283	Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity	2.3%	294	281	$98K
D8670	Periodic orthodontic treatment visit	1.6%	780	702	$71K
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	1.6%	1,251	578	$68K
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	1.0%	898	822	$44K
90837	Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient	<1%	507	304	$34K
D0140	Limited oral evaluation - problem focused	<1%	620	595	$26K
99308	Subsequent nursing facility care, per day, straightforward	<1%	427	388	$26K
H0004	Behavioral health counseling and therapy, per 15 minutes	<1%	534	433	$19K

43 more codes

70450	Computed tomography, head or brain; without contrast material	<1%	576	$18K
D7140	Extraction, erupted tooth or exposed root	<1%	173	$11K
93010	Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only	<1%	903	$8K
D0150	Comprehensive oral evaluation - new or established patient	<1%	425	$8K
D0330	Panoramic radiographic image	<1%	274	$6K
99213	Doctor's office visit, returning patient (routine)	<1%	187	$6K
D1120	Dental cleaning, child	<1%	155	$4K
D1110	Prophylaxis - adult	<1%	123	$4K
D0210	Intraoral - complete series of radiographic images	<1%	102	$3K
99281	Emergency department visit for the evaluation and management, self-limited or minor	<1%	15	$3K
D0120	Dental checkup, returning patient	<1%	160	$3K
D0220	Intraoral - periapical first radiographic image	<1%	406	$3K
D0274	Bitewings - four radiographic images	<1%	103	$3K
99252		<1%	16	$2K
D1208	Topical application of fluoride, excluding varnish	<1%	124	$2K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	<1%	34	$2K
99350	Prolong home eval add 15m	<1%	57	$2K
90834	Psychotherapy session, about 45 minutes	<1%	19	$2K
71010		<1%	251	$2K
74177	Computed tomography, abdomen and pelvis; with contrast material	<1%	25	$2K
93000		<1%	89	$1K
88305	Level IV - Surgical pathology, gross and microscopic examination	<1%	38	$1K
99254		<1%	25	$1K
70496		<1%	28	$1K
93306	Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete	<1%	28	$1K
71045	Radiologic examination, chest; single view	<1%	156	$1K
00740		<1%	12	$1K
72125	Computed tomography, cervical spine; without contrast material	<1%	26	$950.41
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	<1%	14	$940.00
D9995		<1%	170	$840.00
71275	Computed tomographic angiography, chest, with contrast material	<1%	16	$797.66
70498		<1%	16	$646.57
00812		<1%	18	$498.48
D0270		<1%	46	$365.83
92012	Ophthalmological services: medical examination and evaluation, intermediate, established patient	<1%	12	$295.10
99231	Subsequent hospital care, per day, straightforward or low complexity	<1%	34	$277.02
93296		<1%	12	$196.37
71046	Radiologic examination, chest; 2 views	<1%	13	$114.27
76937		<1%	14	$42.43
D0460		<1%	18	$28.51
77001		<1%	16	$14.11
D9430		0%	12	$0.00
G9637	Final reports with documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique)	0%	90	$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 officialACHUFF, HELENE (DIRECTOR)

Same official

Other billing entities under ACHUFF, HELENE

Full network →

Provider	Location	Paid
Einstein Practice Plan INC	Philadelphia, PA	$9.61M
Einstein Practice Plan INC	Philadelphia, PA	$1.11M
Einstein Practice Plan INC	Philadelphia, PA	$243K
Einstein Practice Plan, INC.	Philadelphia, PA	$186K
Einstein Practice Plan, INC.	Philadelphia, PA	$11K

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