Clinic
City Medical of Upper East Side, PLLC
City Medical of Upper East Side, PLLC was paid $643.18M by Medicaid between Jan 2018 and Dec 2024, across 162 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 35% of everything it billed.
33Billing provider infoCITY MEDICAL OF UPPER EAST SIDE, PLLC
NEW YORK, NY 10028
NEW YORK, NY 10028
33aNPI1730491945assigned 07/06/2010
33bProvider typeUrgent Care Clinic/Center
28Total paid$643.18M
24GClaims7,838,014
24DCodes billed162
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Urgent Care Clinic/Center providers in New York
Rank by total paid#1 of 138
Median peer was paid$576K
This provider vs. median1,117×
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 15+ 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 | |
|---|---|---|---|
| 2018 | 297,110 | $28.75M | |
| 2019 | 543,115 | $45.35M | |
| 2020 | 1,083,328 | $87.51M | |
| 2021 | 2,021,953 | $166.11M | |
| 2022 | 1,484,388 | $108.79M | |
| 2023 | 1,468,726 | $116.36M | |
| 2024incomplete | 939,394 | $90.32M |
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 | 35% | 2,049,977 | 1,892,947 | $226.51M |
| S9083 | Global fee urgent care centers | 21% | 868,497 | 793,406 | $135.44M |
| 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 | 17% | 900,091 | 861,119 | $108.67M |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 10% | 651,224 | 649,391 | $66.71M |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 5.2% | 324,553 | 299,107 | $33.15M |
| 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 | 4.5% | 262,867 | 262,217 | $29.09M |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 2.9% | 1,002,033 | 934,317 | $18.53M |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 2.1% | 144,512 | 144,144 | $13.36M |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 336,253 | 175,512 | $1.81M |
| 87428 | <1% | 67,966 | 65,689 | $1.25M | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 7,840 | 7,441 | $991K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 62,965 | 61,626 | $557K |
150 more codes
| 90686 | <1% | 32,509 | $539K | |
| 99201 | <1% | 3,776 | $474K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 3,684 | $473K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 48,164 | $457K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 221,305 | $406K |
| 10060 | <1% | 4,117 | $234K | |
| 12001 | <1% | 4,654 | $218K | |
| 29515 | <1% | 6,251 | $206K | |
| 73610 | <1% | 17,768 | $200K | |
| 93000 | <1% | 34,207 | $193K | |
| 73630 | <1% | 17,860 | $188K | |
| 10061 | <1% | 2,145 | $188K | |
| 99205 | Prolong outpt/office vis | <1% | 1,394 | $183K |
| 90715 | <1% | 10,106 | $181K | |
| 69210 | <1% | 7,121 | $173K | |
| 73562 | <1% | 13,345 | $156K | |
| 29125 | <1% | 4,362 | $146K | |
| 73140 | <1% | 12,424 | $145K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 24,644 | $138K |
| 29130 | <1% | 6,908 | $130K | |
| 73110 | <1% | 9,882 | $125K | |
| 73130 | <1% | 11,208 | $120K | |
| 81025 | <1% | 151,067 | $116K | |
| 90707 | <1% | 5,255 | $114K | |
| 90716 | <1% | 2,286 | $80K | |
| 12011 | <1% | 1,481 | $80K | |
| 90734 | <1% | 2,228 | $69K | |
| 12002 | <1% | 1,180 | $67K | |
| 73030 | <1% | 6,836 | $67K | |
| 26720 | <1% | 860 | $64K | |
| 90746 | <1% | 3,990 | $61K | |
| 81002 | <1% | 68,456 | $61K | |
| 71101 | <1% | 4,392 | $58K | |
| 73080 | <1% | 4,665 | $50K | |
| 31231 | <1% | 234 | $49K | |
| 81003 | <1% | 81,322 | $47K | |
| 10120 | <1% | 630 | $45K | |
| 73660 | <1% | 5,107 | $44K | |
| 16020 | <1% | 1,009 | $39K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 10,940 | $39K |
| 90714 | <1% | 4,830 | $38K | |
| J0561 | Injection, penicillin g benzathine, 100,000 units | <1% | 482 | $36K |
| 72100 | <1% | 3,077 | $34K | |
| 95165 | Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials | <1% | 68 | $34K |
| L3807 | Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | <1% | 1,574 | $33K |
| 69200 | <1% | 979 | $31K | |
| 73502 | <1% | 2,105 | $30K | |
| L3908 | Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf | <1% | 3,005 | $28K |
| 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | <1% | 128 | $25K |
| 90656 | <1% | 2,484 | $24K | |
| L3260 | Surgical boot/shoe, each | <1% | 4,642 | $22K |
| 36415 | Collection of venous blood by venipuncture | <1% | 167,346 | $20K |
| 73590 | <1% | 2,244 | $20K | |
| 28510 | <1% | 578 | $19K | |
| 73090 | <1% | 2,050 | $18K | |
| 90750 | <1% | 200 | $16K | |
| 72040 | <1% | 1,408 | $15K | |
| 86308 | <1% | 6,937 | $15K | |
| 29550 | <1% | 1,734 | $15K | |
| 90675 | <1% | 74 | $15K | |
| 86580 | <1% | 13,133 | $14K | |
| E0114 | Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips | <1% | 5,431 | $14K |
| 90662 | <1% | 648 | $13K | |
| 95117 | <1% | 790 | $11K | |
| L3923 | Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | <1% | 1,054 | $8K |
| 26750 | <1% | 96 | $8K | |
| 70160 | <1% | 539 | $7K | |
| 74019 | <1% | 904 | $7K | |
| 29105 | <1% | 123 | $6K | |
| 90685 | <1% | 443 | $6K | |
| 72070 | <1% | 627 | $6K | |
| 70360 | <1% | 895 | $6K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 2,947 | $6K |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 7,530 | $6K |
| 10160 | <1% | 569 | $5K | |
| S9088 | Services provided in an urgent care center (list in addition to code for service) | <1% | 164 | $5K |
| 72220 | <1% | 481 | $4K | |
| 11740 | <1% | 162 | $4K | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 9,256 | $3K |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 2,494 | $3K |
| 73060 | <1% | 337 | $3K | |
| 86703 | <1% | 728 | $3K | |
| 90682 | <1% | 466 | $3K | |
| 93880 | <1% | 25 | $3K | |
| L1830 | Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf | <1% | 778 | $3K |
| 28490 | <1% | 43 | $3K | |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 28 | $3K |
| 99401 | <1% | 62 | $3K | |
| 90674 | <1% | 391 | $3K | |
| 71045 | Radiologic examination, chest; single view | <1% | 1,160 | $2K |
| 69209 | <1% | 315 | $2K | |
| 31575 | <1% | 14 | $2K | |
| 90619 | <1% | 208 | $2K | |
| 0011A | <1% | 146 | $2K | |
| 92520 | <1% | 25 | $2K | |
| 74018 | <1% | 264 | $2K | |
| 0012A | <1% | 154 | $2K | |
| 73552 | <1% | 154 | $2K | |
| E0100 | Cane, includes canes of all materials, adjustable or fixed, with tip | <1% | 1,679 | $2K |
| 92557 | <1% | 60 | $2K | |
| 82962 | <1% | 12,719 | $1K | |
| 92512 | <1% | 25 | $1K | |
| 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% | 17 | $1K |
| 98925 | <1% | 32 | $1K | |
| A4565 | Slings | <1% | 3,671 | $1K |
| 73650 | <1% | 171 | $1K | |
| 11750 | <1% | 13 | $955.52 | |
| 73000 | <1% | 117 | $921.44 | |
| 36410 | <1% | 972 | $868.34 | |
| 92567 | <1% | 69 | $853.01 | |
| 90632 | <1% | 43 | $617.72 | |
| G0268 | Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing | <1% | 13 | $585.50 |
| 92504 | <1% | 25 | $566.25 | |
| 29540 | <1% | 32 | $449.77 | |
| 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% | 17 | $425.00 |
| S0119 | Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) | <1% | 12 | $422.50 |
| J7620 | Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme | <1% | 6,249 | $280.08 |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | <1% | 93 | $279.56 |
| G0008 | Administration of influenza virus vaccine | <1% | 41 | $115.57 |
| 70150 | <1% | 12 | $82.29 | |
| A9150 | Non-prescription drugs | <1% | 20 | $72.00 |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 116 | $65.62 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 136 | $59.76 |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | <1% | 121 | $55.52 |
| J7512 | Prednisone, immediate release or delayed release, oral, 1 mg | <1% | 258 | $45.60 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 3,144 | $30.25 |
| J8540 | Dexamethasone, oral, 0.25 mg | <1% | 21 | $18.00 |
| 82272 | <1% | 64 | $9.31 | |
| J2765 | Injection, metoclopramide hcl, up to 10 mg | <1% | 29 | $6.42 |
| Q0144 | Azithromycin dihydrate, oral, capsules/powder, 1 gram | <1% | 132 | $4.00 |
| 97602 | <1% | 40 | $3.42 | |
| 99499 | <1% | 2,726 | $1.00 | |
| J7510 | Prednisolone oral, per 5 mg | <1% | 42 | $0.69 |
| 99080 | 0% | 1,161 | $0.00 | |
| 3078F | 0% | 1,133 | $0.00 | |
| J0558 | Injection, penicillin g benzathine and penicillin g procaine, 100,000 units | 0% | 34 | $0.00 |
| J7030 | Infusion, normal saline solution , 1000 cc | 0% | 13 | $0.00 |
| 99173 | 0% | 13 | $0.00 | |
| 3077F | 0% | 264 | $0.00 | |
| 1160F | 0% | 1,868 | $0.00 | |
| 99024 | 0% | 329 | $0.00 | |
| 99429 | 0% | 5,059 | $0.00 | |
| 99000 | 0% | 430 | $0.00 | |
| 3079F | 0% | 679 | $0.00 | |
| 3008F | 0% | 2,520 | $0.00 | |
| 3075F | 0% | 312 | $0.00 | |
| 91301 | 0% | 45 | $0.00 | |
| 1036F | 0% | 1,458 | $0.00 | |
| 3074F | 0% | 1,463 | $0.00 | |
| 3080F | 0% | 223 | $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 (DIR. PROVIDER ENROLLMENT)
| Provider | Location | Paid |
|---|---|---|
| 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.