Physician
Einstein Practice Plan INC
Einstein Practice Plan INC was paid $1.11M by Medicaid between Oct 2020 and Nov 2024, across 19 billing codes. Its largest line is 99291, Critical care, evaluation and management of the critically ill patient, first 30-74 minutes — 26% of everything it billed.
33Billing provider infoEINSTEIN PRACTICE PLAN INC
PHILADELPHIA, PA 19115
PHILADELPHIA, PA 19115
33aNPI1922050509assigned 05/16/2006
33bProvider typeSurgery Physician
28Total paid$1.11M
24GClaims13,012
24DCodes billed19
24AFirst – last monthOct 2020 – Nov 2024
Compared with peers
Next to other Surgery Physician providers in Pennsylvania
Rank by total paid#8 of 190
Median peer was paid$3K
This provider vs. median333×
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.
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 | 748 | $44K | |
| 2021 | 3,821 | $271K | |
| 2022 | 3,285 | $227K | |
| 2023 | 3,315 | $382K | |
| 2024incomplete | 1,843 | $185K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 26% | 1,847 | 946 | $293K |
| 19318 | 20% | 264 | 173 | $225K | |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 12% | 2,230 | 1,434 | $136K |
| 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 | 12% | 1,253 | 1,218 | $132K |
| 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 | 6.9% | 1,576 | 1,523 | $77K |
| 99243 | 4.5% | 578 | 568 | $50K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 3.7% | 1,170 | 1,122 | $41K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 3.2% | 867 | 554 | $35K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | 2.7% | 1,146 | 762 | $29K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | 2.1% | 163 | 163 | $23K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.8% | 710 | 691 | $20K |
| 99242 | 1.5% | 271 | 267 | $17K |
7 more codes
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 officialACHUFF, HELENE (MANAGER)
| Provider | Location | Paid |
|---|---|---|
| Einstein Practice Plan INC | Philadelphia, PA | $9.61M |
| Einstein Practice Plan, INC. | Philadelphia, PA | $4.32M |
| Einstein Practice Plan INC | Philadelphia, PA | $243K |
| Einstein Practice Plan, INC. | Philadelphia, PA | $186K |
| Einstein Practice Plan, INC. | Philadelphia, PA | $11K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.