Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Physician

Einstein Practice Plan, INC

Einstein Practice Plan, INC was paid $1.73M by Medicaid between May 2018 and Dec 2024, across 20 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 53% of everything it billed.

33Billing provider infoEINSTEIN PRACTICE PLAN, INC
PHILADELPHIA, PA 19141
33aNPI1538211552assigned 01/18/2007
28Total paid$1.73M
24GClaims43,250
24DCodes billed20
24AFirst – last monthMay 2018 – Dec 2024
Compared with peers

Next to other Maternal & Fetal Medicine Physician providers in Pennsylvania

Rank by total paid#6 of 60
Median peer was paid$37K
This provider vs. median47×

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 BARGERON, FRANCINE controls 17+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$25K$50K$75K2018201920202021202220232024
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
YearClaimsPaid
2018657$362.92
20201,330$48K
20217,377$269K
20229,376$406K
202311,814$507K
2024incomplete12,696$499K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
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 53% 21,044 20,490 $925K
99232 Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity 29% 10,724 3,721 $501K
99254 6.0% 1,182 1,156 $104K
99244 Office or other outpatient consultation, moderate to high complexity 5.4% 697 689 $94K
95251 3.5% 2,660 2,579 $60K
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) 1.1% 2,177 2,115 $19K
99215 Doctor's office visit, returning patient (complex)Prolong outpt/office vis <1% 86 86 $7K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 1,411 1,389 $6K
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% 143 142 $5K
3074F <1% 1,338 1,315 $3K
3078F <1% 1,147 1,125 $2K
3079F <1% 345 344 $1K
8 more codes
99222 Initial hospital care, per day, moderate complexity <1% 13 $418.86
3077F <1% 115 $360.08
99457 <1% 17 $321.52
3044F <1% 61 $240.00
3075F <1% 53 $160.00
3051F <1% 12 $50.00
99204 Doctor's office visit, new patient (more involved) 0% 12 $0.00
99443 0% 13 $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 officialBARGERON, FRANCINE (DIRECTOR)
Same official

Other billing entities under BARGERON, FRANCINE

Full network →
ProviderLocationPaid
Einstein Practice Plan, INCPhiladelphia, PA$11.46M
Einstein Practice Plan INCPhila, PA$8.02M
Einstein Practice Plan INCPhiladelphia, PA$4.26M
Einstein Practice Plan INCElkins Park, PA$2.02M
Einstein Practice Plan INCPhiladelphia, PA$1.89M
Einstein Practice Plan INCPhiladelphia, PA$1.65M
Einstein Practice Plan INCPhiladelphia, PA$1.40M
Einstein Practice Plan INCPhiladelphia, PA$1.23M
Einstein Practice Plan, INCPhiladelphia, PA$977K
Einstein Practice Plan, INC.Philadelphia, PA$926K
Einstein Practice Plan, INC.Philadelphia, PA$774K
Einstein Practice Plan INCPhiladelphia, PA$636K
Einstein Practice Plan INCPhiladelphia, PA$551K
Einstein Practice Plan INCPhiladelphia, PA$400K
Einstein Practice Plan INCElkins Park, PA$170K
Einstein Practice Plan INCPhiladelphia, PA$15K
Einstein Practice Plan INCPhiladelphia, PA$4K

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