Einstein Practice Plan INC
Einstein Practice Plan INC was paid $624K by Medicaid between Jul 2018 and Dec 2024, across 10 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 49% of everything it billed.
PHILA, PA 19141
Next to other Rheumatology Physician providers in Pennsylvania
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.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 12 | $34.39 | |
| 2020 | 371 | $25K | |
| 2021 | 1,781 | $131K | |
| 2022 | 1,493 | $105K | |
| 2023 | 2,169 | $158K | |
| 2024incomplete | 4,095 | $205K |
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 | 49% | 5,354 | 5,073 | $304K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | 21% | 889 | 882 | $133K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 14% | 1,066 | 1,001 | $89K |
| 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 | 5.5% | 343 | 316 | $34K |
| 99205 | Prolong outpt/office vis | 3.9% | 188 | 187 | $24K |
| 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) | 2.7% | 1,546 | 1,456 | $17K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.3% | 461 | 422 | $14K |
| 99245 | <1% | 26 | 26 | $5K | |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | <1% | 36 | 14 | $2K |
| 99254 | <1% | 12 | 12 | $875.70 |
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.
Who's on the registration
| 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 | $2.98M |
| 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 |
| 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.