Clinic
Primary Health Network
Primary Health Network was paid $3.47M by Medicaid between Jan 2018 and Dec 2024, across 18 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 100% of everything it billed.
33Billing provider infoPRIMARY HEALTH NETWORK
SHARON, PA 16146
SHARON, PA 16146
33aNPI1699226191assigned 10/19/2016
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$3.47M
24GClaims35,010
24DCodes billed18
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Pennsylvania
Rank by total paid#65 of 240
Median peer was paid$909K
This provider vs. median3.8×
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 SIZER, CARL controls 20+ 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 | 4,092 | $289K | |
| 2019 | 5,074 | $392K | |
| 2020 | 3,417 | $257K | |
| 2021 | 5,530 | $494K | |
| 2022 | 5,612 | $590K | |
| 2023 | 6,086 | $739K | |
| 2024incomplete | 5,199 | $710K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 100% | 22,675 | 18,593 | $3.46M |
| 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% | 4,826 | 4,054 | $8K |
| G0467 | Community health center visit, returning patientFederally 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 | <1% | 250 | 190 | $422.31 |
| 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 | <1% | 414 | 375 | $339.10 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,234 | 1,087 | $241.97 |
| 3008F | 0% | 1,183 | 1,118 | $0.00 | |
| D1206 | Topical application of fluoride varnish | 0% | 1,883 | 1,883 | $0.00 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 561 | 509 | $0.00 |
| D1351 | Sealant - per tooth | 0% | 47 | 12 | $0.00 |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | 0% | 50 | 26 | $0.00 |
| 90686 | 0% | 19 | 13 | $0.00 | |
| D1110 | Prophylaxis - adult | 0% | 517 | 517 | $0.00 |
6 more codes
| D1120 | Dental cleaning, child | 0% | 1,250 | $0.00 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 24 | $0.00 |
| 99173 | 0% | 31 | $0.00 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 15 | $0.00 |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 16 | $0.00 |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 0% | 15 | $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 officialSIZER, CARL (CHIEF FINANCIAL OFFICER)
| Provider | Location | 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 | 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 | Shamokin, PA | $1.19M |
| 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 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.