City Medical of Upper East Side, PLLC
City Medical of Upper East Side, PLLC was paid $47K by Medicaid between Nov 2019 and Mar 2020, across 3 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 65% of everything it billed.
ROCKY POINT, NY 11778
Next to other Urgent Care Clinic/Center providers in New York
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.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2019 | 185 | $20K | |
| 2020 | 238 | $26K |
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 | 65% | 275 | 261 | $30K |
| 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 | 32% | 135 | 126 | $15K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 3.1% | 13 | 13 | $1K |
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.
Who's on the registration
| 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 | 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.