Physician
Einstein Practice Plan INC
Einstein Practice Plan INC was paid $2.98M by Medicaid between Apr 2018 and Dec 2024, across 44 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 23% of everything it billed.
33Billing provider infoEINSTEIN PRACTICE PLAN INC
PHILADELPHIA, PA 19141
PHILADELPHIA, PA 19141
33aNPI1598723165assigned 05/03/2006
33bProvider typeCardiovascular Disease Physician
28Total paid$2.98M
24GClaims110,181
24DCodes billed44
24AFirst – last monthApr 2018 – Dec 2024
Compared with peers
Next to other Cardiovascular Disease Physician providers in Pennsylvania
Rank by total paid#4 of 592
Median peer was paid$3K
This provider vs. median949×
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 | 1,468 | $1K | |
| 2019 | 240 | $2K | |
| 2020 | 3,826 | $73K | |
| 2021 | 19,517 | $456K | |
| 2022 | 30,085 | $837K | |
| 2023 | 30,089 | $882K | |
| 2024incomplete | 24,956 | $725K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 23% | 15,355 | 14,739 | $676K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 16% | 11,062 | 10,850 | $486K |
| 93000 | 16% | 27,788 | 26,855 | $483K | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 12% | 40,127 | 35,294 | $356K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 9.5% | 4,261 | 2,308 | $284K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | 8.7% | 1,952 | 1,907 | $258K |
| 99223 | Prolong inpt eval add15 m | 3.2% | 819 | 771 | $97K |
| 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 | 2.1% | 664 | 649 | $63K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 1.6% | 726 | 697 | $46K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 1.5% | 1,221 | 691 | $45K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 1.2% | 281 | 105 | $35K |
| 99254 | 1.2% | 401 | 387 | $35K |
32 more codes
| 99245 | <1% | 178 | $21K | |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 602 | $17K |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 205 | $14K |
| 99152 | <1% | 837 | $12K | |
| 93016 | <1% | 441 | $10K | |
| 93018 | <1% | 441 | $10K | |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | <1% | 55 | $5K |
| 93458 | <1% | 12 | $4K | |
| 99255 | <1% | 15 | $3K | |
| 93308 | <1% | 172 | $3K | |
| 93356 | <1% | 115 | $3K | |
| 99205 | Prolong outpt/office vis | <1% | 25 | $2K |
| 76937 | <1% | 167 | $2K | |
| 3078F | <1% | 913 | $1K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 15 | $1K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 14 | $966.64 |
| 99253 | <1% | 24 | $818.04 | |
| 3077F | <1% | 356 | $751.06 | |
| 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% | 90 | $524.19 |
| 99406 | <1% | 63 | $495.77 | |
| 3074F | <1% | 364 | $411.45 | |
| 99407 | <1% | 15 | $297.61 | |
| 93244 | <1% | 13 | $189.96 | |
| 3080F | <1% | 40 | $135.08 | |
| 93242 | <1% | 12 | $75.59 | |
| 93294 | <1% | 26 | $43.82 | |
| 93296 | <1% | 57 | $23.62 | |
| 3075F | <1% | 13 | $15.00 | |
| 3079F | <1% | 91 | $0.39 | |
| 93295 | 0% | 20 | $0.00 | |
| 93299 | 0% | 66 | $0.00 | |
| 93297 | 0% | 67 | $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 officialJACKSON, MARY (DIRECTOR EINSTEIN PRACTICE PLAN INC)
| Provider | Location | Paid |
|---|---|---|
| Einstein Practice Plan INC | Philadelphia, PA | $13.85M |
| Always on Time Homecare LLC | Luthersville, GA | $8.22M |
| 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.