Einstein Practice Plan INC

Einstein Practice Plan INC was paid $13.85M by Medicaid between Jan 2018 and Dec 2024, across 16 billing codes. Its largest line is 99284, emergency room visit (serious) — 43% of everything it billed.

33Billing provider infoEINSTEIN PRACTICE PLAN INC
PHILADELPHIA, PA 19141

33aNPI1457304198assigned 05/17/2006

33bProvider typeEmergency Medicine Physician

28Total paid$13.85M

24GClaims238,423

24DCodes billed16

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Emergency Medicine Physician providers in Pennsylvania

Rank by total paid#5 of 1,211

Median peer was paid$19K

This provider vs. median711×

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 JACKSON, MARY controls 13+ 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	309	$7K
2019	483	$27K
2020	13,599	$642K
2021	64,018	$2.95M
2022	62,512	$2.77M
2023	58,512	$4.03M
2024incomplete	38,990	$3.42M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99284	Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity	43%	84,552	82,262	$5.99M
99285	Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life	42%	76,198	73,520	$5.88M
99283	Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity	8.5%	25,800	25,023	$1.17M
93010	Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only	2.7%	47,177	44,475	$376K
99291	Critical care, evaluation and management of the critically ill patient, first 30-74 minutes	1.6%	1,374	1,330	$217K
99220		<1%	760	733	$68K
99223	Prolong inpt eval add15 m	<1%	624	600	$57K
99238	Hospital discharge day management, 30 minutes or less	<1%	668	644	$34K
99217		<1%	792	765	$27K
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	<1%	213	165	$11K
99226		<1%	140	131	$7K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	<1%	44	38	$3K

4 more codes

99236	Prolong inpt eval add15 m	<1%	12	$1K
99281	Emergency department visit for the evaluation and management, self-limited or minor	<1%	40	$811.18
99282	Emergency department visit for the evaluation and management, low to moderate severity	<1%	17	$545.03
93308		<1%	12	$231.60

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 officialJACKSON, MARY (DIRECTOR EINSTEIN PRACTICE PLAN INC)

Same official

Other billing entities under JACKSON, MARY

Full network →

Provider	Location	Paid
Always on Time Homecare LLC	Luthersville, GA	$8.22M
Einstein Practice Plan INC	Philadelphia, PA	$2.98M
Einstein Practice Plan INC	Philadelphia, PA	$2.46M
Einstein Practice Plan INC	Philadelphia, PA	$1.99M
Geriatric Care Solutions	Saint Charles, MO	$1.52M
Abbeville County Memorial Hospital	Abbeville, SC	$1.46M
Einstein Practice Plan INC	Phila, PA	$1.05M
Einstein Practice Plan, INC.	Philadelphia, PA	$682K
Einstein Practice Plan INC	Phila, PA	$624K
Abbeville County Memorial Hospital	Due West, SC	$364K
Einstein Practice Plan,inc	Philadelphia, PA	$322K
Einstein Practice Plan INC	Philadelphia, PA	$38K
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.