Clinic
Urban Health Plan, INC.
Urban Health Plan, INC. was paid $61.73M by Medicaid between Jan 2018 and Dec 2024, across 258 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 40% of everything it billed.
33Billing provider infoURBAN HEALTH PLAN, INC.
BRONX, NY 10459
BRONX, NY 10459
33aNPI1265596548assigned 12/20/2006
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$61.73M
24GClaims2,152,814
24DCodes billed258
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in New York
Rank by total paid#6 of 158
Median peer was paid$1.73M
This provider vs. median36×
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.
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 | |
|---|---|---|---|
| 2018 | 292,171 | $8.43M | |
| 2019 | 329,910 | $10.30M | |
| 2020 | 287,526 | $9.27M | |
| 2021 | 326,653 | $10.05M | |
| 2022 | 269,139 | $8.01M | |
| 2023 | 355,786 | $8.72M | |
| 2024incomplete | 291,629 | $6.96M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 40% | 587,475 | 536,073 | $24.80M |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 6.3% | 39,491 | 26,582 | $3.90M |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 5.4% | 21,757 | 13,427 | $3.34M |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 5.3% | 119,867 | 113,531 | $3.26M |
| 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 | 4.5% | 45,041 | 43,048 | $2.77M |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 3.3% | 117,830 | 113,650 | $2.03M |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.7% | 38,224 | 38,146 | $1.67M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 2.0% | 31,776 | 31,675 | $1.25M |
| 99442 | 2.0% | 30,501 | 28,964 | $1.21M | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.6% | 19,158 | 19,121 | $979K |
| 77067 | Screening mammography, bilateral, including computer-aided detection | 1.5% | 8,577 | 8,568 | $917K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 1.4% | 16,355 | 16,311 | $861K |
246 more codes
| 99441 | 1.3% | 35,501 | $789K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 1.2% | 13,942 | $749K |
| 92551 | <1% | 100,306 | $487K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 14,636 | $479K |
| 90461 | <1% | 31,878 | $457K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 5,378 | $451K |
| 97803 | <1% | 20,318 | $409K | |
| 90791 | Psychiatric diagnostic evaluation | <1% | 2,950 | $403K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 6,661 | $401K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 35,920 | $387K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 40,715 | $380K |
| D1110 | Prophylaxis - adult | <1% | 10,667 | $354K |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 8,185 | $345K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 12,459 | $336K |
| 99443 | <1% | 5,474 | $320K | |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 23,115 | $267K |
| D0120 | Dental checkup, returning patient | <1% | 13,774 | $263K |
| 95165 | Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials | <1% | 2,531 | $244K |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 12,053 | $240K |
| 90674 | <1% | 13,141 | $211K | |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | <1% | 2,793 | $199K |
| 76801 | <1% | 1,735 | $187K | |
| 99173 | <1% | 60,967 | $184K | |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 2,555 | $182K |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 845 | $179K |
| 81025 | <1% | 32,708 | $171K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 2,791 | $167K |
| 90686 | <1% | 40,402 | $164K | |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 1,639 | $164K |
| D0274 | Bitewings - four radiographic images | <1% | 8,427 | $156K |
| D1120 | Dental cleaning, child | <1% | 5,198 | $151K |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 872 | $135K |
| 90715 | <1% | 4,961 | $133K | |
| 0001A | <1% | 3,640 | $131K | |
| 0002A | <1% | 3,523 | $128K | |
| 97162 | <1% | 1,646 | $124K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 18,876 | $120K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 4,404 | $116K |
| 81002 | <1% | 52,459 | $114K | |
| D0220 | Intraoral - periapical first radiographic image | <1% | 12,259 | $113K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 9,580 | $102K |
| 95012 | <1% | 5,505 | $101K | |
| 90746 | <1% | 1,681 | $100K | |
| 93000 | <1% | 8,159 | $100K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 865 | $91K |
| 73630 | <1% | 3,148 | $91K | |
| 57454 | <1% | 510 | $89K | |
| 76642 | <1% | 1,323 | $88K | |
| 92250 | <1% | 1,738 | $88K | |
| 97014 | <1% | 8,319 | $87K | |
| 82962 | <1% | 69,375 | $86K | |
| 76641 | <1% | 672 | $84K | |
| 76830 | Ultrasound, transvaginal | <1% | 772 | $82K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 10,401 | $81K |
| 97802 | <1% | 3,711 | $77K | |
| D1351 | Sealant - per tooth | <1% | 2,075 | $73K |
| 0012A | <1% | 2,211 | $71K | |
| 73562 | <1% | 2,088 | $70K | |
| D1206 | Topical application of fluoride varnish | <1% | 3,099 | $69K |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | <1% | 462 | $68K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 6,886 | $68K |
| 72100 | <1% | 1,906 | $62K | |
| 0072A | <1% | 1,679 | $58K | |
| 90732 | <1% | 763 | $58K | |
| 0011A | <1% | 2,207 | $57K | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 1,722 | $56K |
| 77066 | Tomosynthesis, mammo | <1% | 391 | $55K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 2,834 | $55K |
| 0071A | <1% | 1,497 | $53K | |
| 59430 | <1% | 244 | $53K | |
| 73130 | <1% | 1,644 | $51K | |
| 92100 | <1% | 973 | $50K | |
| 73030 | <1% | 1,820 | $50K | |
| 0064A | <1% | 1,564 | $49K | |
| 99381 | <1% | 686 | $49K | |
| 77065 | Tomosynthesis, mammo | <1% | 385 | $42K |
| 11721 | <1% | 2,348 | $42K | |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 551 | $41K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 5,415 | $38K |
| 99385 | <1% | 456 | $38K | |
| D0272 | Bitewings - two radiographic images | <1% | 3,278 | $38K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 744 | $37K |
| 99383 | <1% | 706 | $36K | |
| 90661 | <1% | 1,326 | $33K | |
| 94060 | <1% | 648 | $33K | |
| 95117 | <1% | 2,540 | $30K | |
| A4614 | Peak expiratory flow rate meter, hand held | <1% | 1,546 | $28K |
| T1015 | A visit at a community health center or clinic (one all-in rate) | <1% | 121 | $27K |
| 91322 | <1% | 257 | $25K | |
| 97163 | <1% | 329 | $25K | |
| 0054A | <1% | 719 | $24K | |
| 73610 | <1% | 764 | $23K | |
| D1354 | <1% | 1,493 | $23K | |
| 92020 | <1% | 999 | $23K | |
| 77062 | <1% | 308 | $22K | |
| 92015 | Determination of refractive state | <1% | 3,239 | $22K |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 2,128 | $22K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 1,952 | $21K |
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | <1% | 1,358 | $21K |
| 92229 | <1% | 808 | $21K | |
| 92230 | <1% | 835 | $21K | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 535 | $19K |
| J0561 | Injection, penicillin g benzathine, 100,000 units | <1% | 212 | $19K |
| 90620 | <1% | 1,787 | $18K | |
| D0140 | Limited oral evaluation - problem focused | <1% | 1,985 | $18K |
| 0052A | <1% | 494 | $18K | |
| 0031A | <1% | 638 | $17K | |
| 11056 | <1% | 310 | $15K | |
| D9995 | <1% | 708 | $14K | |
| 0134A | <1% | 415 | $14K | |
| 77061 | <1% | 230 | $13K | |
| 90658 | <1% | 1,499 | $13K | |
| 92225 | <1% | 1,144 | $12K | |
| 94010 | <1% | 1,020 | $12K | |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | <1% | 1,192 | $12K |
| 0051A | <1% | 320 | $11K | |
| 20550 | <1% | 309 | $11K | |
| 99386 | <1% | 106 | $10K | |
| 0004A | <1% | 323 | $10K | |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 213 | $10K |
| 90707 | <1% | 347 | $9K | |
| 72040 | <1% | 287 | $8K | |
| 92557 | <1% | 249 | $8K | |
| 72070 | <1% | 263 | $7K | |
| 72110 | <1% | 158 | $6K | |
| 90694 | <1% | 330 | $6K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 388 | $6K |
| 0034A | <1% | 151 | $5K | |
| 77080 | <1% | 421 | $5K | |
| 90688 | <1% | 668 | $5K | |
| 36416 | <1% | 24,716 | $5K | |
| 3074F | <1% | 34,476 | $5K | |
| 90677 | <1% | 793 | $5K | |
| 99382 | <1% | 67 | $5K | |
| 99348 | <1% | 527 | $5K | |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 269 | $5K |
| 3078F | <1% | 30,432 | $5K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 2,536 | $5K |
| 90480 | <1% | 169 | $5K | |
| 93923 | <1% | 42 | $4K | |
| 0124A | <1% | 131 | $4K | |
| 73110 | <1% | 114 | $4K | |
| 99406 | <1% | 278 | $3K | |
| 3079F | <1% | 13,565 | $3K | |
| D2930 | Prefabricated stainless steel crown - primary tooth | <1% | 44 | $3K |
| 96132 | <1% | 98 | $3K | |
| 11730 | <1% | 32 | $3K | |
| 92568 | <1% | 239 | $3K | |
| 73564 | <1% | 81 | $3K | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 25 | $3K |
| 93224 | <1% | 37 | $3K | |
| 94375 | <1% | 1,004 | $3K | |
| 90651 | <1% | 3,413 | $3K | |
| D0270 | <1% | 273 | $2K | |
| 90656 | <1% | 1,759 | $2K | |
| 96127 | <1% | 1,044 | $2K | |
| 73565 | <1% | 72 | $2K | |
| 92002 | <1% | 30 | $2K | |
| 99384 | <1% | 26 | $2K | |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 73 | $2K |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 881 | $2K |
| 90619 | <1% | 602 | $2K | |
| 90839 | <1% | 13 | $2K | |
| 3075F | <1% | 4,965 | $2K | |
| 0112A | <1% | 39 | $2K | |
| 99397 | <1% | 132 | $1K | |
| 94729 | <1% | 32 | $1K | |
| 90621 | <1% | 147 | $1K | |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | <1% | 17 | $1K |
| 90734 | <1% | 909 | $1K | |
| 97010 | <1% | 9,673 | $1K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 419 | $1K |
| 90756 | <1% | 68 | $1K | |
| 0111A | <1% | 28 | $1K | |
| S0620 | Routine ophthalmological examination including refraction; new patient | <1% | 55 | $1K |
| 90685 | <1% | 921 | $1K | |
| 0144A | <1% | 25 | $1K | |
| 90633 | <1% | 3,691 | $869.66 | |
| 90670 | <1% | 7,379 | $869.25 | |
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 19 | $769.80 |
| 90671 | <1% | 696 | $742.96 | |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | <1% | 20 | $709.73 |
| 92550 | <1% | 46 | $690.98 | |
| D0330 | Panoramic radiographic image | <1% | 37 | $686.27 |
| 96160 | <1% | 481 | $649.14 | |
| 90672 | <1% | 3,476 | $609.13 | |
| 85610 | <1% | 195 | $577.42 | |
| 0003A | <1% | 21 | $514.52 | |
| 94726 | <1% | 12 | $494.37 | |
| 72081 | <1% | 15 | $444.34 | |
| 90653 | <1% | 156 | $440.71 | |
| 11055 | <1% | 12 | $432.82 | |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | <1% | 12 | $420.00 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 331 | $418.37 |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 17 | $407.50 |
| 94761 | <1% | 264 | $348.98 | |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | <1% | 12 | $348.72 |
| 90660 | <1% | 320 | $340.42 | |
| 3044F | <1% | 1,180 | $300.00 | |
| A7004 | Small volume nonfiltered pneumatic nebulizer, disposable | <1% | 291 | $287.09 |
| S0621 | Routine ophthalmological examination including refraction; established patient | <1% | 14 | $280.00 |
| V2020 | Frames, purchases | <1% | 12 | $252.00 |
| J0558 | Injection, penicillin g benzathine and penicillin g procaine, 100,000 units | <1% | 30 | $246.09 |
| 92202 | <1% | 41 | $210.75 | |
| 3077F | <1% | 2,379 | $209.50 | |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | <1% | 13 | $122.66 |
| 1126F | <1% | 128 | $115.00 | |
| 86580 | <1% | 13 | $91.97 | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 13 | $69.04 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 247 | $66.28 |
| 90710 | <1% | 378 | $35.70 | |
| 96146 | <1% | 100 | $17.67 | |
| J2357 | Injection, omalizumab, 5 mg | <1% | 809 | $0.09 |
| 1160F | <1% | 3,436 | $0.01 | |
| 90723 | 0% | 3,505 | $0.00 | |
| 90647 | 0% | 3,408 | $0.00 | |
| 90716 | 0% | 274 | $0.00 | |
| 90680 | 0% | 177 | $0.00 | |
| 90696 | 0% | 226 | $0.00 | |
| 3080F | 0% | 420 | $0.00 | |
| 88142 | 0% | 368 | $0.00 | |
| 90697 | 0% | 956 | $0.00 | |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 122 | $0.00 |
| D0170 | 0% | 137 | $0.00 | |
| 92567 | 0% | 219 | $0.00 | |
| 2033F | 0% | 282 | $0.00 | |
| G8981 | Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals | 0% | 12 | $0.00 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 17 | $0.00 |
| 90698 | 0% | 13 | $0.00 | |
| G8982 | Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting | 0% | 12 | $0.00 |
| 99072 | 0% | 11,754 | $0.00 | |
| 2022F | 0% | 844 | $0.00 | |
| 90681 | 0% | 1,183 | $0.00 | |
| 1159F | 0% | 791 | $0.00 | |
| 90700 | 0% | 105 | $0.00 | |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 83 | $0.00 |
| 99499 | 0% | 2,980 | $0.00 | |
| G8730 | Pain assessment documented as positive using a standardized tool and a follow-up plan is documented | 0% | 171 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 171 | $0.00 |
| G8539 | Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies is documented within two days of the functional outcome assessment | 0% | 26 | $0.00 |
| 3046F | 0% | 51 | $0.00 | |
| 90713 | 0% | 46 | $0.00 | |
| 2026F | 0% | 13 | $0.00 | |
| G8979 | Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting | 0% | 13 | $0.00 |
| G8978 | Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals | 0% | 13 | $0.00 |
| G8783 | Normal blood pressure reading documented, follow-up not required | 0% | 14 | $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 officialDELEON, SAMUEL (MD, VP/CMO)
| Provider | Location | Paid |
|---|---|---|
| Vail Healthcare Medical PLLC | Bronx, NY | $1.10M |
| Multimedic Medical Services PLLC | Bronx, NY | $55K |
| Urban Health Plan, INC. | Bronx, NY | $29K |
| Urban Health Plan, INC. | Corona, NY | $9K |
| Urban Health Plan, INC | Bronx, NY | $1K |
| Urban Health Plan, INC. | Bronx, NY | $863.27 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.