Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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PRIMARY HEALTH NETWORK

NPI: 1699226191 · SHARON, PA 16146 · Federally Qualified Health Center (FQHC) · NPI assigned 10/19/2016

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official SIZER, CARL controls 20+ related entities in our dataset. Read more

$3.47M
Total Medicaid Paid
35,010
Total Claims
29,724
Beneficiaries
18
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialSIZER, CARL (CHIEF FINANCIAL OFFICER)
NPI Enumeration Date10/19/2016

Related Entities

Other providers sharing the same authorized official: SIZER, CARL

ProviderCityStateTotal 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

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal 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
2024 5,199 $710K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 22,675 18,593 $3.46M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 4,826 4,054 $8K
G0467 Federally 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 250 190 $422.31
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 414 375 $339.10
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 1,234 1,087 $241.97
3008F 1,183 1,118 $0.00
D1206 Topical application of fluoride varnish 1,883 1,883 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 561 509 $0.00
D1351 Sealant - per tooth 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 50 26 $0.00
90686 19 13 $0.00
D1110 Prophylaxis - adult 517 517 $0.00
D1120 Prophylaxis - child 1,250 1,250 $0.00
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 24 24 $0.00
99173 31 31 $0.00
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 15 12 $0.00
G0444 Annual depression screening, 5 to 15 minutes 16 16 $0.00
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 15 14 $0.00