Physician
Prospect Health Access Network, INC.
Prospect Health Access Network, INC. was paid $266K by Medicaid between Nov 2020 and Jun 2024, across 8 billing codes. Its largest line is 20611, — 40% of everything it billed.
33Billing provider infoPROSPECT HEALTH ACCESS NETWORK, INC.
SPRINGFIELD, PA 19064
SPRINGFIELD, PA 19064
33aNPI1528413002assigned 05/03/2016
33bProvider typeSports Medicine (Family Medicine) Physician
28Total paid$266K
24GClaims5,442
24DCodes billed8
24AFirst – last monthNov 2020 – Jun 2024
Compared with peers
Next to other Sports Medicine (Family Medicine) Physician providers in Pennsylvania
Rank by total paid#4 of 49
Median peer was paid$16K
This provider vs. median16×
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 ELDERS, ROBERT 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 | |
|---|---|---|---|
| 2020 | 150 | $7K | |
| 2021 | 1,271 | $69K | |
| 2022 | 1,449 | $73K | |
| 2023 | 1,887 | $89K | |
| 2024incomplete | 685 | $29K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 20611 | 40% | 1,920 | 1,477 | $106K | |
| 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 | 25% | 1,215 | 1,054 | $66K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 22% | 1,441 | 1,353 | $58K |
| 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 | 7.2% | 186 | 184 | $19K |
| 20610 | 2.8% | 235 | 182 | $8K | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.7% | 63 | 63 | $5K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | 1.5% | 26 | 26 | $4K |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 356 | 340 | $162.40 |
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 officialELDERS, ROBERT (SECRETARY)
| Provider | Location | Paid |
|---|---|---|
| Prospect Waterbury, INC. | Waterbury, CT | $84.62M |
| Prospect Manchester Hospital, INC. | Manchester, CT | $69.20M |
| Prospect Chartercare RWMC, LLC | Providence, RI | $57.10M |
| Prospect CCMC, LLC | Chester, PA | $40.89M |
| Prospect CT Medical Foundation, INC. | Manchester, CT | $34.07M |
| Prospect Rockville Hospital, INC. | Vernon, CT | $30.06M |
| Prospect Chartercare Sjhsri, LLC | North Providence, RI | $10.94M |
| Prospect DCMH, LLC | Drexel Hill, PA | $10.37M |
| Prospect CCMC, LLC | Chester, PA | $5.46M |
| Alta Los Angeles Hospitals, INC. | Los Angeles, CA | $5.42M |
| Prospect CCMC, LLC | Chester, PA | $5.03M |
| Prospect CCMC, LLC | Chester, PA | $3.71M |
| Prospect Chartercare Physicians, LLC | Cranston, RI | $2.31M |
| Prospect Echn Home Health, INC. | Vernon, CT | $1.75M |
| Prospect Waterbury Home Health, INC. | Watertown, CT | $1.30M |
| Prospect Health Access Network, INC. | Chester, PA | $1.22M |
| Alta Newport Hospital, LLC | Tustin, CA | $1.16M |
| Prospect Health Access Network, INC. | Crum Lynne, PA | $924K |
| Prospect Health Access Network, INC. | Chester, PA | $872K |
| Prospect Chartercare Sjhsri, LLC | North Providence, RI | $858K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.