Physician
Einstein Practice Plan INC
Einstein Practice Plan INC was paid $8.02M by Medicaid between Aug 2018 and Dec 2024, across 96 billing codes. Its largest line is 99391, Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) — 22% of everything it billed.
33Billing provider infoEINSTEIN PRACTICE PLAN INC
PHILA, PA 19141
PHILA, PA 19141
33aNPI1730132028assigned 05/18/2006
33bProvider typePediatrics Physician
28Total paid$8.02M
24GClaims255,336
24DCodes billed96
24AFirst – last monthAug 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Pennsylvania
Rank by total paid#7 of 1,257
Median peer was paid$45K
This provider vs. median177×
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 | |
|---|---|---|---|
| 2018 | 77 | $1K | |
| 2019 | 257 | $6K | |
| 2020 | 16,702 | $546K | |
| 2021 | 68,422 | $2.17M | |
| 2022 | 65,921 | $1.93M | |
| 2023 | 55,263 | $1.81M | |
| 2024incomplete | 48,694 | $1.56M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 22% | 18,678 | 17,640 | $1.74M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 15% | 10,972 | 10,742 | $1.19M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 12% | 24,170 | 23,523 | $1.00M |
| 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 | 6.2% | 8,194 | 7,806 | $500K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 5.6% | 6,225 | 6,063 | $447K |
| 99460 | 5.1% | 4,115 | 3,949 | $412K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 4.8% | 22,058 | 20,843 | $386K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 4.0% | 4,105 | 4,001 | $324K |
| 99238 | Hospital discharge day management, 30 minutes or less | 3.7% | 6,037 | 5,816 | $297K |
| 92551 | 2.6% | 15,392 | 15,066 | $210K | |
| 99479 | Subsequent intensive care, per day, very low birth weight infant | 1.8% | 1,351 | 476 | $145K |
| 99469 | Subsequent inpatient neonatal critical care, per day, 28 days or younger | 1.5% | 417 | 116 | $122K |
84 more codes
| 99462 | 1.3% | 3,633 | $105K | |
| 96112 | 1.0% | 1,296 | $84K | |
| 99177 | <1% | 7,042 | $79K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 875 | $76K |
| 99245 | <1% | 434 | $73K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 754 | $70K |
| 90461 | <1% | 5,033 | $58K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 2,207 | $57K |
| 90686 | <1% | 11,312 | $47K | |
| 99480 | Subsequent intensive care, per day, low birth weight infant | <1% | 473 | $45K |
| 99173 | <1% | 13,527 | $43K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 389 | $38K |
| 90670 | <1% | 7,603 | $37K | |
| 99188 | <1% | 1,779 | $35K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 9,751 | $30K |
| 99223 | Prolong inpt eval add15 m | <1% | 210 | $29K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 4,206 | $28K |
| 90680 | <1% | 5,699 | $25K | |
| 96127 | <1% | 5,013 | $22K | |
| 90698 | <1% | 4,505 | $22K | |
| 99464 | <1% | 414 | $21K | |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 311 | $18K |
| 99499 | <1% | 452 | $17K | |
| 99219 | <1% | 151 | $15K | |
| 90633 | <1% | 4,103 | $14K | |
| 90744 | <1% | 2,300 | $13K | |
| 90677 | <1% | 2,068 | $12K | |
| D8670 | Periodic orthodontic treatment visit | <1% | 257 | $11K |
| 90697 | <1% | 4,099 | $11K | |
| 90620 | <1% | 1,052 | $9K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 750 | $7K |
| 90716 | <1% | 1,873 | $7K | |
| 90707 | <1% | 1,746 | $6K | |
| 99442 | <1% | 239 | $6K | |
| 90651 | <1% | 1,760 | $6K | |
| 90734 | <1% | 1,176 | $6K | |
| 90710 | <1% | 1,402 | $5K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 329 | $5K |
| 81025 | <1% | 917 | $4K | |
| 90696 | <1% | 1,321 | $4K | |
| 90715 | <1% | 1,081 | $4K | |
| 0071A | <1% | 83 | $3K | |
| 96161 | <1% | 3,314 | $3K | |
| 90656 | <1% | 776 | $3K | |
| 99477 | <1% | 12 | $3K | |
| 83655 | <1% | 491 | $3K | |
| 99441 | <1% | 105 | $2K | |
| D0140 | Limited oral evaluation - problem focused | <1% | 109 | $2K |
| 0124A | <1% | 51 | $2K | |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 19 | $2K |
| D0330 | Panoramic radiographic image | <1% | 64 | $2K |
| 90649 | <1% | 191 | $2K | |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 99 | $2K |
| D1110 | Prophylaxis - adult | <1% | 58 | $2K |
| 99384 | <1% | 15 | $1K | |
| D0210 | Intraoral - complete series of radiographic images | <1% | 41 | $1K |
| 0072A | <1% | 28 | $1K | |
| 99383 | <1% | 12 | $766.96 | |
| 99217 | <1% | 12 | $742.48 | |
| D0274 | Bitewings - four radiographic images | <1% | 33 | $705.60 |
| D0220 | Intraoral - periapical first radiographic image | <1% | 100 | $692.80 |
| 0051A | <1% | 15 | $629.86 | |
| 99000 | <1% | 10,562 | $542.60 | |
| 0052A | <1% | 13 | $528.00 | |
| 90619 | <1% | 285 | $519.13 | |
| D0120 | Dental checkup, returning patient | <1% | 27 | $486.00 |
| G0008 | Administration of influenza virus vaccine | <1% | 47 | $343.49 |
| 90700 | <1% | 118 | $231.50 | |
| D1120 | Dental cleaning, child | <1% | 12 | $217.80 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 29 | $211.84 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 12 | $189.58 |
| 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% | 28 | $189.45 |
| 88720 | <1% | 40 | $180.06 | |
| D0270 | <1% | 13 | $86.40 | |
| 90688 | <1% | 12 | $70.00 | |
| 96160 | <1% | 77 | $39.24 | |
| 90713 | <1% | 125 | $14.00 | |
| 36416 | <1% | 303 | $2.50 | |
| G9920 | Screening performed and negative | <1% | 2,549 | $0.94 |
| G9919 | Screening performed and positive and provision of recommendations | <1% | 40 | $0.06 |
| C3000 | 0% | 18 | $0.00 | |
| 91322 | 0% | 14 | $0.00 | |
| 90682 | 0% | 115 | $0.00 | |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 13 | $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 officialBARGERON, FRANCINE (DIRECTOR)
| Provider | Location | Paid |
|---|---|---|
| Einstein Practice Plan, INC | Philadelphia, PA | $11.46M |
| 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 | $1.40M |
| 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.