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 1396703955)

Einstein Practice Plan Inc is a diagnostic radiology physician provider located in Philadelphia, Pennsylvania. This profile covers 0 Medicare and 91 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	5501 Old York Rd
City	Philadelphia
State	PA
ZIP	19141
Taxonomy	Diagnostic Radiology Physician
NPI Enumerated	May 3, 2006

Payer Source	Total Paid
Medicaid	$9.6M
Medicare	$0

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

91 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	18,980	$80	$1.5M
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	25,950	$40	$1M
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	20,340	$40	$793.3K
77063	The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis…	20,300	$30	$608.9K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	71,270	$10	$570.2K
72125	In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the cervical spine without contrast material.	8,090	$60	$461.3K
71275	In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a…	4,750	$100	$460.7K
70496	The provider injects contrast material into a peripheral vein and images the blood vessels in the patient's head using computed tomographic scanning. Noncontrast images, if performed, are included in…	4,270	$100	$409.5K
70498	The provider injects contrast material into a peripheral vein and images the blood vessels in the patient's neck using computed tomographic scanning. Noncontrast images, if performed, are included in…	4,020	$90	$378.1K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	35,370	$10	$353.7K

Showing 1–10 of 91

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 — 23 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

91 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	8	480	260	$90	$115.3K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	14	150	130	$180	$95K
70551	The provider uses magnetic resonance imaging, or MRI, to examine the brain and brain stem. The provider does not administer contrast for this exam.	5	140	100	$160	$71.3K
74183	The provider performs magnetic resonance imaging of the structures and organs of the abdomen, initially without control and then with additional sequences after injection of contrast.	26	40	80	$270	$71.2K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	5	370	250	$50	$64.7K
73701	In this procedure, the provider performs a computed tomography, or CT, scan of a patient’s lower extremity using contrast material. The provider performs this radiology procedure for diagnosis of a…	3	10	100	$70	$57.2K
49083	In this procedure, the provider withdraws an abnormal buildup of fluid from the abdominal cavity to relieve pressure and pain or to obtain a sample to submit to a laboratory for analysis. He…	5	10	70	$240	$56.4K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	7	510	250	$40	$56.2K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	612	610	90	$60	$50.1K
73721	In this diagnostic procedure, the provider performs magnetic resonance imaging of a lower extremity joint without using contrast material.	6	140	120	$150	$49.4K

Showing 1–10 of 91

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Einstein Practice Plan Inc	PA	Emergency Medicine Physician	$0	$13.9M
Einstein Practice Plan, Inc	PA	Obstetrics & Gynecology Physician	$0	$11.4M
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
Patriot Home Care, Inc	PA	Home Health Agency	$0	$135.9M
Albert Einstein Medical Center	PA	General Acute Care Hospital	$0	$81.1M
Dr Warren E Smith Community Mental Health Mental Retardation & Substan	PA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$34.5M
Pathways To Housing PA, Inc.	PA	Case Management Agency	$0	$26.4M
Albert Einstein Medical Center	PA	Rehabilitation Hospital Unit	$0	$14.5M
Resources For Human Development, Inc.	PA	Case Management Agency	$0	$7.1M
Chad Home Health Agency, Inc.	PA	Home Health Agency	$0	$6M
Ruchika Patel	PA	Rheumatology Physician	$1.5M	$0
Denise Najjar	PA	Neuropathology Physician	$856.4K	$1.8K
Thomas Egizi	PA	Diagnostic Radiology Physician	$475.4K	$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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