Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Pennsylvania for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Pennsylvania only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Pennsylvania (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Einstein Practice Plan, Inc (NPI 1154355220)

Einstein Practice Plan, Inc is a obstetrics & gynecology physician provider located in Philadelphia, Pennsylvania. This profile covers 0 Medicare and 63 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Einstein Practice Plan, Inc
Address	101 E Olney Ave
City	Philadelphia
State	PA
ZIP	19120
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	July 11, 2006

Payer Source	Total Paid
Medicaid	$11.4M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

63 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	30,010	$80	$2.5M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	39,280	$50	$1.8M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	14,500	$60	$913.8K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	15,160	$50	$788.3K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	5,090	$140	$691.7K
76801	In this procedure, the provider performs a real time or live image, ultrasound of a pregnant uterus for examination of the first or a single fetus and mother during the first trimester, or less than…	6,120	$70	$422.3K
G0101	Cervical or vaginal cancer screening; pelvic and clinical breast examination	8,090	$50	$396.4K
Q0091	Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory	6,790	$50	$366.4K
76813	The provider uses either a transabdominal or transvaginal ultrasound to measure the fetal nuchal translucency, or the clear, fluid–filled space at the back of the neck, of the first or a single…	4,990	$60	$314.2K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	13,330	$20	$239.9K

Showing 1–10 of 63

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.

Claims Volume vs. Pennsylvania Distribution

Einstein Practice Plan, Inc — 20 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

63 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	13	30	180	$570	$331.3K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	331	980	310	$50	$136.6K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	3	100	300	$130	$129.8K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	4	20	40	$1,340	$124.9K
99241	Office consultation for a new or established patient, which requires these three key components: a problem focused history; a problem focused examination; and straightforward medical decision making.…	31	60	490	$90	$122.3K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	2	200	330	$60	$95.3K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	89	8,160	210	$60	$68.4K
99201	Deleted code, effective Jan. 1, 2021	77	110	150	$80	$61.7K
99429	Use 99429 to report a preventive medicine service that does not have a specific code.	4	30	90	$260	$57.3K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	37	8,870	240	$40	$56.1K

Showing 1–10 of 63

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Einstein Practice Plan Inc	PA	Emergency Medicine Physician	$0	$13.9M
Einstein Practice Plan Inc	PA	Diagnostic Radiology Physician	$0	$9.6M
Einstein Practice Plan Inc	PA	Pediatrics Physician	$0	$8M
Amjad Safvi	IL	Vascular & Interventional Radiology Physician	$568.9K	$765.4K
Joel Wolf	PA	Vascular & Interventional Radiology Physician	$1.3M	$4.7K
Tracey Evans	PA	Hematology & Oncology Physician	$1.3M	$0
Shikha Rathi	PA	Rheumatology Physician	$687.3K	$0
NPI 1760480586	—	—	$627.5K	$0
Charles Ko	NJ	Diagnostic Radiology Physician	$575.3K	$0
Vivek Sehgal	NJ	Diagnostic Radiology Physician	$281.4K	$265.1K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Einstein Community Health Associates, Inc	PA	Family Medicine Physician	$0	$17.6M
Public Health Management Corporation	PA	Federally Qualified Health Center (FQHC)	$0	$11.3M
Truong Nguyen	PA	Internal Medicine Physician	$312.5K	$145.3K
Armen Voskeridjian	PA	Anesthesiology Physician	$28.1K	$0

Einstein Practice Plan, Inc — Billing Profile & Reimbursement Data

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Einstein Practice Plan, Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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