Physician
Prospect Health Access Network, INC.
Prospect Health Access Network, INC. was paid $651K by Medicaid between Apr 2018 and Nov 2024, across 33 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 57% of everything it billed.
33Billing provider infoPROSPECT HEALTH ACCESS NETWORK, INC.
CHESTER, PA 19013
CHESTER, PA 19013
33aNPI1912354432assigned 05/16/2016
33bProvider typeRheumatology Physician
28Total paid$651K
24GClaims37,243
24DCodes billed33
24AFirst – last monthApr 2018 – Nov 2024
Compared with peers
Next to other Rheumatology Physician providers in Pennsylvania
Rank by total paid#4 of 77
Median peer was paid$7K
This provider vs. median98×
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 | |
|---|---|---|---|
| 2018 | 350 | $7K | |
| 2019 | 20 | $0.00 | |
| 2020 | 2,104 | $43K | |
| 2021 | 8,679 | $157K | |
| 2022 | 8,884 | $152K | |
| 2023 | 9,180 | $152K | |
| 2024incomplete | 8,026 | $139K |
Box 24 · Service lines
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 | 57% | 18,432 | 17,589 | $374K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 17% | 4,874 | 4,210 | $108K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 15% | 7,038 | 6,807 | $97K |
| 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 | 2.7% | 258 | 254 | $17K |
| 90686 | 2.2% | 1,481 | 1,471 | $14K | |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 1.9% | 621 | 610 | $12K |
| 99308 | Subsequent nursing facility care, per day, straightforward | 1.3% | 373 | 331 | $9K |
| 99349 | <1% | 218 | 204 | $3K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 172 | 171 | $2K |
| 90715 | <1% | 63 | 62 | $2K | |
| 90656 | <1% | 198 | 198 | $2K | |
| 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% | 570 | 535 | $1K |
21 more codes
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 101 | $1K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 17 | $1K |
| 90732 | <1% | 27 | $972.33 | |
| 3074F | <1% | 648 | $943.71 | |
| 3079F | <1% | 566 | $773.92 | |
| 90662 | <1% | 85 | $666.10 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 67 | $643.48 |
| 99385 | <1% | 15 | $595.81 | |
| 99318 | <1% | 17 | $526.53 | |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 22 | $366.19 |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 27 | $356.25 |
| 3078F | <1% | 201 | $350.98 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 312 | $302.13 |
| 86580 | <1% | 285 | $261.64 | |
| 82962 | <1% | 350 | $253.51 | |
| 3077F | <1% | 78 | $80.56 | |
| 3725F | <1% | 46 | $30.40 | |
| 3075F | <1% | 36 | $30.26 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 12 | $13.86 |
| 3080F | <1% | 13 | $0.10 | |
| 90653 | 0% | 20 | $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.