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 Community Health Associates, Inc (NPI 1558316109)

Einstein Community Health Associates, Inc is a family medicine physician provider located in Phila, Pennsylvania. This profile covers 0 Medicare and 102 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 Community Health Associates, Inc
Address	101 E Olney Ave
City	Phila
State	PA
ZIP	19120
Taxonomy	Family Medicine Physician
NPI Enumerated	May 23, 2006

Payer Source	Total Paid
Medicaid	$17.6M
Medicare	$0

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

102 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	78,340	$50	$3.6M
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…	93,380	$30	$3.2M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	26,360	$110	$2.8M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	20,760	$100	$2.1M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	23,350	$60	$1.5M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	15,650	$70	$1.1M
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	39,630	$10	$475.6K
92551	The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems.	32,360	$10	$420.7K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	2,780	$90	$252.8K
99188	The provider applies a fluoride adhesive over the tooth surface to prevent tooth decay, provide remineralization, or treat hypersensitivity.	10,660	$20	$202.6K

Showing 1–10 of 102

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 Community Health Associates, Inc — 24 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

102 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1	820	230	$80	$71.7K
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…	6	8,160	210	$60	$68.4K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1	660	180	$70	$63.7K
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…	8	8,870	240	$40	$56.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1	870	160	$70	$48.2K
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…	253	1,210	100	$90	$45K
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…	679	1,300	110	$40	$41.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1	730	90	$70	$31.5K
99204	The provider sees a new 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 provider…	121	1,410	60	$90	$30.5K
99203	The provider sees a new 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 provider…	389	1,620	80	$60	$28.4K

Showing 1–10 of 102

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Phuong Tien	PA	Family Medicine Physician	$243.5K	$16.3K
Aasia Ferdous	PA	Geriatric Medicine (Internal Medicine) Physician	$221.7K	$0
Kevin Zakrzewski	PA	Internal Medicine Physician	$202.4K	$0
Lilian Jalil	PA	Internal Medicine Physician	$150.1K	$0
Christopher Kirby	PA	Family Medicine Physician	$101K	$0
Christopher Drumm	PA	Family Medicine Physician	$66.2K	$0
Jeannine Weimar-fitzpatrick	PA	Family Medicine Physician	$64.7K	$0
Marcia Reynolds	DE	Family Nurse Practitioner	$49.9K	$0
Jennifer Dupre	PA	Family Medicine Physician	$49.2K	$0
Anthony Wydan	PA	Family Medicine Physician	$44.4K	$0

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