Prospect Health Access Network, INC.
Prospect Health Access Network, INC. was paid $259K by Medicaid between Jul 2018 and Nov 2024, across 8 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 81% of everything it billed.
SPRINGFIELD, PA 19064
Next to other Endocrinology, Diabetes & Metabolism 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 | 13 | $50.62 | |
| 2020 | 215 | $10K | |
| 2021 | 1,394 | $68K | |
| 2022 | 1,189 | $66K | |
| 2023 | 1,125 | $58K | |
| 2024incomplete | 1,126 | $56K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 81% | 3,860 | 3,791 | $209K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 11% | 778 | 761 | $30K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 6.2% | 151 | 147 | $16K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 25 | 25 | $2K |
| 95251 | <1% | 54 | 54 | $2K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 31 | 27 | $1K |
| 3074F | <1% | 112 | 110 | $0.86 | |
| 3078F | <1% | 51 | 49 | $0.38 |
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 |
|---|---|---|
| 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.