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 1457304198)

Field	Value
Entity Type	Organization
Organization	Einstein Practice Plan Inc
Address	5501 Old York Road
City	Philadelphia
State	PA
ZIP	19141
Taxonomy	Emergency Medicine Physician
NPI Enumerated	May 17, 2006

Payer Source	Total Paid
Medicaid	$13.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	84,550	$70	$6M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	76,200	$80	$5.9M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	25,800	$50	$1.2M
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	47,180	$10	$377.4K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	1,370	$160	$217.1K
99220	N/A	760	$90	$67.6K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	620	$90	$57.4K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	670	$50	$34.1K
99217	N/A	790	$40	$27.7K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	210	$50	$10.7K

Showing 1–10 of 16

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 — 5 of 16 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

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	10	1,600	270	$120	$409.7K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	27	1,060	150	$130	$405.4K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	2	1,230	250	$130	$284K
99281	The provider sees a patient for the lowest level emergency department visit.	91	120	190	$130	$90.3K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	295	340	250	$80	$89K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	21	250	80	$140	$74.1K
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…	412	610	90	$60	$50.1K
93308	The provider performs a limited or follow–up transthoracic echocardiography to obtain a two dimensional (2D) image of the heart through the chest wall. It is a limited examination of a focused…	32	40	100	$100	$42.6K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	487	1,300	110	$40	$41.5K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	45	480	40	$100	$27.9K

Showing 1–10 of 16

Related Providers

Other providers that share a Tax Identification Number (TIN) with Einstein Practice Plan Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Einstein Practice Plan, Inc	PA	Obstetrics & Gynecology Physician	$0	$11.4M
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

Nearby Providers

Other providers in the same ZIP code as Einstein Practice Plan Inc, ranked by combined Medicare and Medicaid revenue.

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

Related Providers

Nearby Providers

Frequently Asked Questions

References