Einstein Practice Plan INC
Einstein Practice Plan INC was paid $4.26M by Medicaid between May 2018 and Dec 2024, across 14 billing codes. Its largest line is 99232, hospital visit by a doctor, follow-up day — 39% of everything it billed.
PHILADELPHIA, PA 19141
Next to other Internal Medicine Physician providers in Pennsylvania
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.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 423 | $495.25 | |
| 2020 | 3,203 | $62K | |
| 2021 | 14,947 | $546K | |
| 2022 | 21,127 | $1.24M | |
| 2023 | 20,904 | $1.32M | |
| 2024incomplete | 15,268 | $1.09M |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 39% | 38,117 | 18,695 | $1.68M |
| 99223 | Prolong inpt eval add15 m | 25% | 9,281 | 8,928 | $1.07M |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 20% | 14,609 | 8,677 | $869K |
| 99238 | Hospital discharge day management, 30 minutes or less | 5.4% | 7,864 | 7,414 | $229K |
| 99222 | Initial hospital care, per day, moderate complexity | 5.0% | 2,459 | 2,362 | $212K |
| 99239 | Hospital discharge day management, more than 30 minutes | 2.6% | 1,571 | 1,485 | $110K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 1,124 | 526 | $30K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 159 | 145 | $25K |
| 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% | 384 | 365 | $24K |
| 99220 | <1% | 84 | 81 | $7K | |
| 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% | 152 | 140 | $4K |
| 99217 | <1% | 31 | 29 | $1K |
2 more codes
| 99225 | <1% | 22 | $619.58 | |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 15 | $363.15 |
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.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| Einstein Practice Plan, INC | Philadelphia, PA | $11.46M |
| Einstein Practice Plan INC | Phila, PA | $8.02M |
| 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.