Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Physician

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.

33Billing provider infoEINSTEIN PRACTICE PLAN INC
PHILADELPHIA, PA 19141
33aNPI1801853288assigned 04/28/2006
28Total paid$4.26M
24GClaims75,872
24DCodes billed14
24AFirst – last monthMay 2018 – Dec 2024
Compared with peers

Next to other Internal Medicine Physician providers in Pennsylvania

Rank by total paid#4 of 1,726
Median peer was paid$6K
This provider vs. median658×

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

$0$50K$100K$150K2018201920202021202220232024
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
YearClaimsPaid
2018423$495.25
20203,203$62K
202114,947$546K
202221,127$1.24M
202320,904$1.32M
2024incomplete15,268$1.09M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
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.

From NPPES

Who's on the registration

Authorized officialBARGERON, FRANCINE (DIRECTOR EINSTEIN PRACTICE PLAN INC)
Same official

Other billing entities under BARGERON, FRANCINE

Full network →
ProviderLocationPaid
Einstein Practice Plan, INCPhiladelphia, PA$11.46M
Einstein Practice Plan INCPhila, PA$8.02M
Einstein Practice Plan INCElkins Park, PA$2.02M
Einstein Practice Plan INCPhiladelphia, PA$1.89M
Einstein Practice Plan, INCPhiladelphia, PA$1.73M
Einstein Practice Plan INCPhiladelphia, PA$1.65M
Einstein Practice Plan INCPhiladelphia, PA$1.40M
Einstein Practice Plan INCPhiladelphia, PA$1.23M
Einstein Practice Plan, INCPhiladelphia, PA$977K
Einstein Practice Plan, INC.Philadelphia, PA$926K
Einstein Practice Plan, INC.Philadelphia, PA$774K
Einstein Practice Plan INCPhiladelphia, PA$636K
Einstein Practice Plan INCPhiladelphia, PA$551K
Einstein Practice Plan INCPhiladelphia, PA$400K
Einstein Practice Plan INCElkins Park, PA$170K
Einstein Practice Plan INCPhiladelphia, PA$15K
Einstein Practice Plan INCPhiladelphia, PA$4K

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.