Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

PRIMARY HEALTH NETWORK

NPI: 1528526217 · SHAMOKIN, PA 17872 · Federally Qualified Health Center (FQHC) · NPI assigned 03/12/2019

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official SIZER, CARL controls 20+ related entities in our dataset. Read more

$1.19M
Total Medicaid Paid
13,262
Total Claims
12,324
Beneficiaries
10
Codes Billed
2019-06
First Month
2024-12
Last Month

Provider Details

Authorized OfficialSIZER, CARL (CHIEF FINANCIAL OFFICER)
NPI Enumeration Date03/12/2019

Related Entities

Other providers sharing the same authorized official: SIZER, CARL

ProviderCityStateTotal 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 BEAVER FALLS PA $1.02M
PRIMARY HEALTH NETWORK LATROBE PA $914K
PRIMARY HEALTH NETWORK FARRELL PA $622K
PRIMARY HEALTH NETWORK ERIE PA $546K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2019 451 $36K
2020 1,179 $108K
2021 2,503 $203K
2022 2,624 $235K
2023 3,444 $329K
2024 3,061 $282K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 5,730 5,210 $1.19M
0011A 49 48 $2K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 1,517 1,483 $1K
0012A 20 20 $760.00
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 2,321 2,154 $643.12
G8510 Screening for depression is documented as negative, a follow-up plan is not required 776 715 $0.00
3008F 2,742 2,598 $0.00
G2025 Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only 32 24 $0.00
91301 61 60 $0.00
G0467 Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit 14 12 $0.00