Clinic
City Medical of Upper East Side, PLLC
City Medical of Upper East Side, PLLC was paid $4.09M by Medicaid between Jun 2021 and Dec 2024, across 88 billing codes. Its largest line is 99204, doctor's office visit, new patient (more involved) — 29% of everything it billed.
33Billing provider infoCITY MEDICAL OF UPPER EAST SIDE, PLLC
HUNTINGTON, NY 11743
HUNTINGTON, NY 11743
33aNPI1043815848assigned 12/01/2020
33bProvider typeUrgent Care Clinic/Center
28Total paid$4.09M
24GClaims95,878
24DCodes billed88
24AFirst – last monthJun 2021 – Dec 2024
Compared with peers
Next to other Urgent Care Clinic/Center providers in New York
Rank by total paid#25 of 138
Median peer was paid$576K
This provider vs. median7.1×
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 HENRY, SWAHILI controls 16+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
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
| Year | Claims | Paid | |
|---|---|---|---|
| 2021 | 404 | $44K | |
| 2022 | 9,255 | $714K | |
| 2023 | 52,112 | $2.15M | |
| 2024incomplete | 34,107 | $1.18M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 29% | 8,505 | 8,502 | $1.20M |
| 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 | 23% | 9,914 | 9,157 | $958K |
| 31231 | 8.9% | 2,092 | 1,986 | $363K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 7.6% | 4,025 | 3,768 | $313K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 6.4% | 2,535 | 2,532 | $261K |
| 95165 | Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials | 3.9% | 421 | 411 | $161K |
| 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | 3.1% | 830 | 827 | $125K |
| 30469 | 2.3% | 43 | 43 | $92K | |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 2.0% | 515 | 514 | $80K |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | 1.2% | 634 | 621 | $47K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 1.0% | 181 | 181 | $42K |
| 88313 | <1% | 132 | 132 | $40K |
76 more codes
| 30117 | <1% | 74 | $34K | |
| 95117 | <1% | 2,414 | $28K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 180 | $27K |
| 92557 | <1% | 832 | $27K | |
| 31237 | <1% | 107 | $26K | |
| 93880 | <1% | 177 | $24K | |
| 92512 | <1% | 359 | $19K | |
| 88312 | <1% | 103 | $17K | |
| 92504 | <1% | 635 | $17K | |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 | <1% | 628 | $16K |
| 69210 | <1% | 2,023 | $15K | |
| 93925 | <1% | 95 | $13K | |
| 31575 | <1% | 110 | $12K | |
| 93978 | <1% | 117 | $12K | |
| 98925 | <1% | 461 | $12K | |
| 93000 | <1% | 1,043 | $12K | |
| 11104 | <1% | 85 | $11K | |
| 92567 | <1% | 543 | $8K | |
| 73140 | <1% | 213 | $8K | |
| 99205 | Prolong outpt/office vis | <1% | 28 | $5K |
| 94729 | <1% | 93 | $5K | |
| 99441 | <1% | 184 | $4K | |
| 95816 | <1% | 12 | $4K | |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 151 | $3K |
| 99401 | <1% | 210 | $3K | |
| 92520 | <1% | 147 | $3K | |
| 3074F | <1% | 5,115 | $3K | |
| 92550 | <1% | 144 | $3K | |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 25 | $3K |
| 93015 | <1% | 49 | $2K | |
| 93975 | <1% | 12 | $2K | |
| G0268 | Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing | <1% | 203 | $2K |
| 73130 | <1% | 46 | $2K | |
| 99385 | <1% | 67 | $2K | |
| 93886 | <1% | 12 | $2K | |
| 3078F | <1% | 3,220 | $2K | |
| 93892 | <1% | 12 | $1K | |
| 87340 | <1% | 132 | $1K | |
| 86803 | <1% | 128 | $1K | |
| 92511 | <1% | 12 | $1K | |
| 30801 | <1% | 14 | $1K | |
| 93922 | <1% | 48 | $999.87 | |
| 92653 | <1% | 12 | $878.68 | |
| L3908 | Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf | <1% | 13 | $846.61 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 250 | $794.90 |
| 87510 | <1% | 59 | $789.42 | |
| 11721 | <1% | 25 | $687.68 | |
| 29130 | <1% | 17 | $687.64 | |
| 87428 | <1% | 34 | $631.04 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 58 | $551.77 |
| 73110 | <1% | 12 | $471.24 | |
| 87660 | <1% | 28 | $376.65 | |
| 92552 | <1% | 12 | $365.61 | |
| 29550 | <1% | 22 | $336.69 | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 92 | $305.87 |
| 3079F | <1% | 925 | $190.00 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 673 | $88.14 |
| 81002 | <1% | 33 | $46.92 | |
| 87088 | <1% | 39 | $34.00 | |
| 92551 | <1% | 14 | $33.54 | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 39 | $33.00 |
| 87070 | <1% | 21 | $24.45 | |
| Q9966 | Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml | <1% | 14 | $13.14 |
| 87077 | <1% | 14 | $8.08 | |
| 87186 | <1% | 15 | $6.59 | |
| 1159F | 0% | 7,594 | $0.00 | |
| 1160F | 0% | 7,593 | $0.00 | |
| 3725F | 0% | 1,933 | $0.00 | |
| 72100 | 0% | 43 | $0.00 | |
| 99173 | 0% | 17 | $0.00 | |
| 1036F | 0% | 15,525 | $0.00 | |
| 3008F | 0% | 10,026 | $0.00 | |
| 96127 | 0% | 172 | $0.00 | |
| 1034F | 0% | 52 | $0.00 | |
| 3075F | 0% | 60 | $0.00 | |
| 1125F | 0% | 352 | $0.00 |
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 officialHENRY, SWAHILI (DIRECTOR OF PAYMENT SOLUTIONS)
Parent organizationCITY MEDICAL OF UPPER EAST SIDE, PLLC
| Provider | Location | Paid |
|---|---|---|
| City Medical of Upper East Side, PLLC | New York, NY | $643.18M |
| Westchester Medical Group, P.C. | Rye Brook, NY | $16.09M |
| Summit Medical Group PA | Berkeley Heights, NJ | $6.74M |
| City Medical of Upper East Side, PLLC | New York, NY | $260K |
| City Medical of Upper East Side, PLLC | Deer Park, NY | $90K |
| City Medical of Upper East Side, PLLC | Bay Shore, NY | $89K |
| City Medical of Upper East Side, PLLC | Sayville, NY | $81K |
| City Medical of Upper East Side, PLLC | Selden, NY | $80K |
| City Medical of Upper East Side, PLLC | Ronkonkoma, NY | $62K |
| City Medical of Upper East Side, PLLC | Port Jefferson Station, NY | $61K |
| City Medical of Upper East Side, PLLC | Rocky Point, NY | $47K |
| City Medical of Upper East Side, PLLC | Riverhead, NY | $44K |
| City Medical of Upper East Side, PLLC | Brooklyn, NY | $41K |
| City Medical of Upper East Side, PLLC | Smithtown, NY | $14K |
| City Medical of Upper East Side, PLLC | Plainview, NY | $7K |
| Summit Medical Group PA | Berkeley Heights, NJ | $5K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.