Physician
Einstein Practice Plan INC
Einstein Practice Plan INC was paid $1.40M by Medicaid between Sep 2020 and Dec 2024, across 20 billing codes. Its largest line is 43239, Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple — 21% of everything it billed.
33Billing provider infoEINSTEIN PRACTICE PLAN INC
PHILADELPHIA, PA 19141
PHILADELPHIA, PA 19141
33aNPI1679525372assigned 05/17/2006
33bProvider typeGastroenterology Physician
28Total paid$1.40M
24GClaims15,376
24DCodes billed20
24AFirst – last monthSep 2020 – Dec 2024
Compared with peers
Next to other Gastroenterology Physician providers in Pennsylvania
Rank by total paid#3 of 178
Median peer was paid$6K
This provider vs. median243×
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
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 | 269 | $33K | |
| 2021 | 1,189 | $113K | |
| 2022 | 4,384 | $425K | |
| 2023 | 5,124 | $461K | |
| 2024incomplete | 4,410 | $364K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 21% | 2,098 | 2,040 | $300K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 17% | 788 | 770 | $244K |
| 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 | 12% | 3,463 | 3,373 | $172K |
| 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 | 10% | 1,437 | 1,395 | $141K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 7.3% | 2,978 | 2,928 | $102K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 6.7% | 433 | 430 | $94K |
| 99243 | 5.7% | 878 | 872 | $80K | |
| 99244 | Office or other outpatient consultation, moderate to high complexity | 4.8% | 452 | 448 | $67K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 4.7% | 336 | 321 | $66K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 4.1% | 974 | 960 | $57K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 2.5% | 480 | 203 | $35K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | <1% | 218 | 145 | $12K |
8 more codes
| 99242 | <1% | 142 | $9K | |
| 99254 | <1% | 133 | $8K | |
| 91200 | <1% | 255 | $4K | |
| 99245 | <1% | 12 | $2K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 36 | $2K |
| 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% | 232 | $1K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 19 | $638.72 |
| 99253 | <1% | 12 | $454.40 |
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 officialBARGERON, FRANCINE (DIRECTOR EINSTEIN PRACTICE PLAN INC)
| Provider | Location | Paid |
|---|---|---|
| Einstein Practice Plan, INC | Philadelphia, PA | $11.46M |
| Einstein Practice Plan INC | Phila, PA | $8.02M |
| Einstein Practice Plan INC | Philadelphia, PA | $4.26M |
| Einstein Practice Plan INC | Elkins Park, PA | $2.02M |
| Einstein Practice Plan INC | Philadelphia, PA | $1.89M |
| Einstein Practice Plan, INC | Philadelphia, PA | $1.73M |
| Einstein Practice Plan INC | Philadelphia, PA | $1.65M |
| Einstein Practice Plan INC | Philadelphia, PA | $1.23M |
| Einstein Practice Plan, INC | Philadelphia, PA | $977K |
| Einstein Practice Plan, INC. | Philadelphia, PA | $926K |
| Einstein Practice Plan, INC. | Philadelphia, PA | $774K |
| Einstein Practice Plan INC | Philadelphia, PA | $636K |
| Einstein Practice Plan INC | Philadelphia, PA | $551K |
| Einstein Practice Plan INC | Philadelphia, PA | $400K |
| Einstein Practice Plan INC | Elkins Park, PA | $170K |
| Einstein Practice Plan INC | Philadelphia, PA | $15K |
| 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.