Physician
Metropolitan Medical Practice Plan PC
Metropolitan Medical Practice Plan PC was paid $4.54M by Medicaid between Jan 2018 and Jun 2024, across 77 billing codes. Its largest line is 99284, emergency room visit (serious) — 17% of everything it billed.
33Billing provider infoMETROPOLITAN MEDICAL PRACTICE PLAN PC
NEW YORK, NY 10029
NEW YORK, NY 10029
33aNPI1306138383assigned 05/09/2011
33bProvider typeGeneral Practice Physician
28Total paid$4.54M
24GClaims120,260
24DCodes billed77
24AFirst – last monthJan 2018 – Jun 2024
Compared with peers
Next to other General Practice Physician providers in New York
Rank by total paid#9 of 178
Median peer was paid$27K
This provider vs. median169×
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 | 10,996 | $287K | |
| 2019 | 14,742 | $427K | |
| 2020 | 15,223 | $527K | |
| 2021 | 18,706 | $732K | |
| 2022 | 24,046 | $887K | |
| 2023 | 25,585 | $1.21M | |
| 2024incomplete | 10,962 | $473K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 17% | 8,411 | 8,263 | $788K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 17% | 15,434 | 15,235 | $776K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 11% | 10,406 | 4,817 | $499K |
| 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 | 11% | 10,579 | 10,347 | $485K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.8% | 7,323 | 7,101 | $264K |
| 99442 | 5.1% | 5,092 | 4,974 | $231K | |
| 99443 | 3.4% | 2,167 | 2,076 | $156K | |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 3.1% | 4,301 | 4,239 | $140K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 2.8% | 20,402 | 15,917 | $126K |
| 90792 | Psychiatric diagnostic evaluation with medical services | 2.7% | 1,022 | 999 | $121K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | 2.7% | 4,137 | 2,255 | $121K |
| 99222 | Initial hospital care, per day, moderate complexity | 1.8% | 951 | 928 | $80K |
65 more codes
| 99238 | Hospital discharge day management, 30 minutes or less | 1.7% | 1,507 | $77K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 1.6% | 1,664 | $74K |
| 99285 | Emergency room visit (most serious) | 1.5% | 522 | $67K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 1.3% | 1,564 | $61K |
| 77067 | Screening mammography, bilateral, including computer-aided detection | 1.2% | 2,532 | $55K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,499 | $38K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 646 | $36K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 4,234 | $31K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 808 | $28K |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 870 | $21K |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 1,091 | $19K |
| 93970 | <1% | 839 | $18K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 315 | $17K |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | <1% | 247 | $17K |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 1,156 | $17K |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 309 | $17K |
| 71045 | Radiologic examination, chest; single view | <1% | 2,841 | $16K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 591 | $14K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 365 | $14K |
| 88307 | <1% | 134 | $13K | |
| 76819 | Fetal biophysical profile; without non-stress testing | <1% | 390 | $12K |
| 59425 | <1% | 120 | $10K | |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 159 | $9K |
| 99218 | <1% | 126 | $9K | |
| 76641 | <1% | 331 | $8K | |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 118 | $7K |
| 99223 | Prolong inpt eval add15 m | <1% | 41 | $6K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 200 | $5K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 1,181 | $5K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 87 | $4K |
| 73630 | <1% | 821 | $4K | |
| 99221 | <1% | 58 | $4K | |
| 76801 | <1% | 86 | $3K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 24 | $3K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 227 | $1K |
| 94729 | <1% | 253 | $1K | |
| 94726 | <1% | 165 | $1K | |
| 76770 | <1% | 55 | $932.86 | |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | <1% | 29 | $752.29 |
| 99460 | <1% | 12 | $728.11 | |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 14 | $688.00 |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 24 | $670.43 |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 29 | $576.91 |
| 99462 | <1% | 22 | $574.82 | |
| 99441 | <1% | 66 | $499.33 | |
| 93016 | <1% | 39 | $463.07 | |
| 76820 | <1% | 26 | $463.00 | |
| 94010 | <1% | 89 | $371.19 | |
| 71250 | <1% | 13 | $324.58 | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 15 | $310.81 |
| 76536 | <1% | 12 | $179.14 | |
| 73610 | <1% | 29 | $166.40 | |
| 99446 | <1% | 69 | $97.79 | |
| 73560 | <1% | 17 | $85.43 | |
| 93018 | <1% | 12 | $69.90 | |
| 3078F | 0% | 60 | $0.00 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 704 | $0.00 |
| G9916 | Functional status performed once in the last 12 months | 0% | 12 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 98 | $0.00 |
| 1159F | 0% | 49 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 290 | $0.00 |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 12 | $0.00 |
| 3008F | 0% | 40 | $0.00 | |
| 1170F | 0% | 64 | $0.00 | |
| 3074F | 0% | 13 | $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 officialPENTYALA, SUDHA (DIRECTOR)
| Provider | Location | Paid |
|---|---|---|
| Harlem Medical Associates PC | New York, NY | $8.11M |
| Coney Island Medical Practice Plan, P.C. | Brooklyn, NY | $7.04M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.