Primary Health Network

Primary Health Network was paid $363K by Medicaid between May 2019 and Aug 2024, across 5 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 100% of everything it billed.

33Billing provider infoPRIMARY HEALTH NETWORK
SHENANDOAH, PA 17976

33aNPI1407359060assigned 03/09/2018

33bProvider typeFederally Qualified Health Center (FQHC)

28Total paid$363K

24GClaims3,246

24DCodes billed5

24AFirst – last monthMay 2019 – Aug 2024

Compared with peers

Next to other Federally Qualified Health Center (FQHC) providers in Pennsylvania

Rank by total paid#150 of 240

Median peer was paid$909K

This provider vs. median0.4×

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 SIZER, CARL controls 20+ 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
2019	62	$4K
2020	321	$26K
2021	320	$41K
2022	668	$83K
2023	1,181	$142K
2024incomplete	694	$67K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
T1015	A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive	100%	1,681	1,430	$361K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	<1%	1,020	890	$1K
3008F		0%	322	287	$0.00
G8510	Screening for depression is documented as negative, a follow-up plan is not required	0%	202	173	$0.00
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	0%	21	20	$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 officialSIZER, CARL (CHIEF FINANCIAL OFFICER)

Same official

Other billing entities under SIZER, CARL

Full network →

Provider	Location	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	Rochester, PA	$1.66M
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

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