Clinic
Vertex LLC
Vertex LLC was paid $24.56M by Medicaid between Jan 2019 and Dec 2024, across 8 billing codes. Its largest line is G0397, Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes — 43% of everything it billed.
33Billing provider infoVERTEX LLC
BRONX, NY 10469
BRONX, NY 10469
33aNPI1831377407assigned 02/06/2008
33bProvider typeSubstance Use Disorder Rehabilitation Clinic/Center
28Total paid$24.56M
24GClaims234,740
24DCodes billed8
24AFirst – last monthJan 2019 – Dec 2024
Compared with peers
Next to other Substance Use Disorder Rehabilitation Clinic/Center providers in New York
Rank by total paid#4 of 64
Median peer was paid$2.18M
This provider vs. median11×
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 | |
|---|---|---|---|
| 2019 | 5,145 | $489K | |
| 2020 | 27,751 | $2.58M | |
| 2021 | 61,966 | $5.96M | |
| 2022 | 46,320 | $4.96M | |
| 2023 | 45,537 | $4.98M | |
| 2024incomplete | 48,021 | $5.60M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| G0397 | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes | 43% | 67,539 | 18,344 | $10.51M |
| G0396 | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes | 28% | 60,458 | 14,584 | $6.85M |
| H0005 | Alcohol and/or drug services; group counseling by a clinician | 25% | 99,582 | 17,098 | $6.06M |
| H0001 | Alcohol and/or drug assessment | 3.3% | 4,670 | 3,672 | $803K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 1.1% | 1,808 | 1,772 | $266K |
| 99201 | <1% | 428 | 214 | $40K | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 225 | 223 | $29K |
| 99406 | <1% | 30 | 30 | $663.00 |
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 officialGORNOPOLSKY, ZOYA (PRESIDENT)