Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

PRIMARY HEALTH NETWORK

NPI: 1982159786 · SHARON, PA 16146 · Federally Qualified Health Center (FQHC) · NPI assigned 08/22/2016

Billing Flags · Automated signals — not evidence of fraud
Single-Code Concentration

100% of spending on code T1015 with only 1 total codes billed. Highly concentrated billing profile.

Entity Proliferation

Authorized official SIZER, CARL controls 20+ related entities in our dataset. Read more

$2.51M
Total Medicaid Paid
13,360
Total Claims
11,574
Beneficiaries
1
Codes Billed
2018-09
First Month
2024-03
Last Month

Provider Details

Authorized OfficialSIZER, CARL (CHIEF FINANCIAL OFFICER)
NPI Enumeration Date08/22/2016

Related Entities

Other providers sharing the same authorized official: SIZER, CARL

ProviderCityStateTotal Paid
PRIMARY HEALTH NETWORK SHARON PA $57.95M
PRIMARY HEALTH NETWORK ALTOONA PA $19.65M
PRIMARY HEALTH NETWORK MERCER PA $12.27M
PRIMARY HEALTH NETWORK FARRELL PA $5.60M
PRIMARY HEALTH NETWORK LEWISTOWN PA $5.05M
PRIMARY HEALTH NETWORK CLARION PA $3.53M
PRIMARY HEALTH NETWORK SHARON PA $3.47M
PRIMARY HEALTH NETWORK NEW CASTLE PA $3.21M
PRIMARY HEALTH NETWORK GREENVILLE PA $2.39M
PRIMARY HEALTH NETWORK INDIANA PA $1.94M
PRIMARY HEALTH NETWORK NEW CASTLE PA $1.84M
PRIMARY HEALTH NETWORK ROCHESTER PA $1.66M
PRIMARY HEALTH NETWORK SHEAKLEYVILLE PA $1.65M
PRIMARY HEALTH NETWORK WARREN PA $1.28M
PRIMARY HEALTH NETWORK MINERSVILLE PA $1.24M
PRIMARY HEALTH NETWORK SHAMOKIN PA $1.19M
PRIMARY HEALTH NETWORK BEAVER FALLS PA $1.02M
PRIMARY HEALTH NETWORK LATROBE PA $914K
PRIMARY HEALTH NETWORK FARRELL PA $622K
PRIMARY HEALTH NETWORK ERIE PA $546K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 22 $888.83
2019 57 $3K
2020 2,926 $491K
2021 1,988 $312K
2022 3,519 $687K
2023 4,185 $871K
2024 663 $150K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 13,360 11,574 $2.51M