Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
Home › PA › Philadelphia › NPI 1992761621
Physician

Einstein Practice Plan INC

Einstein Practice Plan INC was paid $400K by Medicaid between Jul 2018 and Dec 2024, across 12 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 46% of everything it billed.

33Billing provider infoEINSTEIN PRACTICE PLAN INC
PHILADELPHIA, PA 19141
33aNPI1992761621assigned 04/21/2006
33bProvider typeVascular Surgery Physician
28Total paid$400K
24GClaims11,297
24DCodes billed12
24AFirst – last monthJul 2018 – Dec 2024
Compared with peers

Next to other Vascular Surgery Physician providers in Pennsylvania

Rank by total paid#2 of 42
Median peer was paid$3K
This provider vs. median115×

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$5.0K$10K$15K2018201920202021202220232024
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
201825$0.00
2020417$14K
20212,169$70K
20222,924$96K
20232,926$111K
2024incomplete2,836$109K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 46% 5,753 4,516 $184K
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 33% 2,963 2,756 $133K
93970 8.0% 935 896 $32K
93971 3.7% 668 647 $15K
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 2.6% 139 134 $10K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 2.2% 275 232 $9K
93923 1.9% 390 378 $8K
99244 Office or other outpatient consultation, moderate to high complexity 1.2% 40 40 $5K
93880 <1% 67 67 $2K
99232 Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity <1% 37 24 $1K
11045 <1% 15 12 $986.64
3078F <1% 15 14 $50.00

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 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 INCPhiladelphia, PA$4.26M
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 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.