Physician
Prospect Health Access Network, INC.
Prospect Health Access Network, INC. was paid $392K by Medicaid between Oct 2020 and Jan 2024, across 37 billing codes. Its largest line is 99460, — 26% of everything it billed.
33Billing provider infoPROSPECT HEALTH ACCESS NETWORK, INC.
CHESTER, PA 19013
CHESTER, PA 19013
33aNPI1780031005assigned 05/17/2016
33bProvider typePediatrics Physician
28Total paid$392K
24GClaims22,805
24DCodes billed37
24AFirst – last monthOct 2020 – Jan 2024
Compared with peers
Next to other Pediatrics Physician providers in Pennsylvania
Rank by total paid#243 of 1,257
Median peer was paid$45K
This provider vs. median8.6×
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 ELDERS, ROBERT 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 | |
|---|---|---|---|
| 2020 | 2,162 | $30K | |
| 2021 | 8,181 | $149K | |
| 2022 | 7,081 | $129K | |
| 2023 | 4,969 | $80K | |
| 2024incomplete | 412 | $4K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99460 | 26% | 1,127 | 1,077 | $102K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 22% | 2,097 | 2,018 | $86K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 18% | 2,061 | 2,054 | $70K |
| 99239 | Hospital discharge day management, more than 30 minutes | 6.5% | 566 | 552 | $25K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 5.9% | 896 | 890 | $23K |
| 90686 | 2.5% | 2,129 | 2,118 | $10K | |
| 90670 | 2.5% | 1,295 | 1,290 | $10K | |
| 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% | 868 | 840 | $9K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.8% | 186 | 185 | $7K |
| 99238 | Hospital discharge day management, 30 minutes or less | 1.7% | 240 | 231 | $7K |
| 90648 | 1.5% | 1,297 | 1,291 | $6K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.2% | 2,178 | 2,165 | $5K |
25 more codes
| 99188 | 1.1% | 234 | $4K | |
| 90723 | 1.0% | 903 | $4K | |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 355 | $4K |
| 90633 | <1% | 623 | $3K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 204 | $2K |
| 92551 | <1% | 1,065 | $2K | |
| 90734 | <1% | 302 | $1K | |
| 99173 | <1% | 1,569 | $1K | |
| 90681 | <1% | 339 | $1K | |
| 90651 | <1% | 248 | $1K | |
| 90710 | <1% | 173 | $1K | |
| 90700 | <1% | 174 | $943.19 | |
| 90707 | <1% | 177 | $877.46 | |
| 90716 | <1% | 135 | $803.17 | |
| 83655 | <1% | 66 | $726.52 | |
| 90696 | <1% | 121 | $676.37 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 25 | $629.16 |
| 90715 | <1% | 114 | $582.25 | |
| 90620 | <1% | 76 | $532.00 | |
| 96161 | <1% | 456 | $527.09 | |
| 90680 | <1% | 63 | $464.16 | |
| 85018 | <1% | 241 | $178.68 | |
| 99462 | <1% | 13 | $145.52 | |
| 96127 | <1% | 148 | $59.63 | |
| 36416 | 0% | 41 | $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 officialELDERS, ROBERT (SECRETARY)
| Provider | Location | Paid |
|---|---|---|
| Prospect Waterbury, INC. | Waterbury, CT | $84.62M |
| Prospect Manchester Hospital, INC. | Manchester, CT | $69.20M |
| Prospect Chartercare RWMC, LLC | Providence, RI | $57.10M |
| Prospect CCMC, LLC | Chester, PA | $40.89M |
| Prospect CT Medical Foundation, INC. | Manchester, CT | $34.07M |
| Prospect Rockville Hospital, INC. | Vernon, CT | $30.06M |
| Prospect Chartercare Sjhsri, LLC | North Providence, RI | $10.94M |
| Prospect DCMH, LLC | Drexel Hill, PA | $10.37M |
| Prospect CCMC, LLC | Chester, PA | $5.46M |
| Alta Los Angeles Hospitals, INC. | Los Angeles, CA | $5.42M |
| Prospect CCMC, LLC | Chester, PA | $5.03M |
| Prospect CCMC, LLC | Chester, PA | $3.71M |
| Prospect Chartercare Physicians, LLC | Cranston, RI | $2.31M |
| Prospect Echn Home Health, INC. | Vernon, CT | $1.75M |
| Prospect Waterbury Home Health, INC. | Watertown, CT | $1.30M |
| Prospect Health Access Network, INC. | Chester, PA | $1.22M |
| Alta Newport Hospital, LLC | Tustin, CA | $1.16M |
| Prospect Health Access Network, INC. | Crum Lynne, PA | $924K |
| Prospect Health Access Network, INC. | Chester, PA | $872K |
| Prospect Chartercare Sjhsri, LLC | North Providence, RI | $858K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.