Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

WESTCHESTER MEDICAL GROUP, P.C.

NPI: 1881653822 · RYE BROOK, NY 10573 · Pediatrics Physician · NPI assigned 03/20/2006

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official HENRY, SWAHILI controls 15+ related entities in our dataset. Read more

$16.09M
Total Medicaid Paid
340,445
Total Claims
312,394
Beneficiaries
240
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialHENRY, SWAHILI (DIRECTOR OF ENROLLMENT)
NPI Enumeration Date03/20/2006

Related Entities

Other providers sharing the same authorized official: HENRY, SWAHILI

ProviderCityStateTotal Paid
CITY MEDICAL OF UPPER EAST SIDE, PLLC NEW YORK NY $643.18M
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

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 23,296 $897K
2019 25,951 $948K
2020 34,585 $1.19M
2021 38,128 $1.75M
2022 54,252 $2.89M
2023 105,933 $5.55M
2024 58,300 $2.87M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 46,169 41,919 $4.38M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 26,757 23,422 $3.01M
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 2,917 2,852 $589K
77067 Screening mammography, bilateral, including computer-aided detection 4,080 4,064 $583K
88305 Level IV - Surgical pathology, gross and microscopic examination 4,228 4,067 $583K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 3,911 3,848 $532K
90460 Immunization administration through 18 years of age via any route, first or only component 20,656 20,505 $407K
76641 3,152 2,019 $361K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 2,165 2,162 $317K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 2,298 2,298 $308K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 4,855 1,829 $307K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 2,290 2,250 $264K
76830 Ultrasound, transvaginal 1,987 1,951 $252K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 1,595 1,576 $234K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 1,401 1,383 $219K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 1,476 1,476 $198K
88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer 7,495 7,475 $196K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types 4,335 4,316 $154K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 4,446 4,413 $143K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 4,430 4,397 $142K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 2,022 1,931 $131K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 3,785 1,418 $122K
92551 13,333 13,319 $121K
90960 End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits 2,444 2,000 $121K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 915 887 $112K
80061 Lipid panel 8,440 8,400 $91K
99215 Prolong outpt/office vis 427 416 $91K
76700 Ultrasound, abdominal, real time with image documentation; complete 725 722 $87K
71046 Radiologic examination, chest; 2 views 2,362 2,331 $81K
90834 Psychotherapy, 45 minutes with patient 944 598 $78K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 630 574 $78K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 11,044 10,603 $71K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 5,773 5,742 $64K
20611 501 397 $61K
80050 General health panel 1,734 1,731 $56K
99385 341 339 $55K
20610 690 591 $55K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 606 370 $54K
88312 343 343 $53K
83036 Hemoglobin; glycosylated (A1C) 6,072 6,033 $46K
90961 1,479 1,157 $46K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 1,886 1,831 $45K
36415 Collection of venous blood by venipuncture 25,981 24,167 $43K
99232 Subsequent hospital care, per day, moderate complexity 2,512 713 $35K
80048 Basic metabolic panel (calcium, ionized) 4,299 4,270 $34K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 155 152 $33K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 2,606 1,339 $33K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 2,880 2,816 $33K
80053 Comprehensive metabolic panel 3,838 3,720 $31K
J1756 Injection, iron sucrose, 1 mg 371 210 $30K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 1,452 1,446 $29K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 1,046 364 $29K
80076 3,711 3,687 $28K
93000 1,622 1,589 $27K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 115 115 $27K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 163 163 $26K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 989 984 $23K
84443 Thyroid stimulating hormone (TSH) 1,934 1,904 $23K
90791 Psychiatric diagnostic evaluation 191 166 $22K
99386 109 108 $20K
82728 1,780 1,735 $20K
90715 423 423 $19K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 58 58 $19K
99173 4,580 4,575 $19K
70551 Magnetic resonance imaging, brain; without contrast material 81 81 $17K
90674 625 624 $17K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 323 317 $17K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 591 581 $16K
90686 1,897 1,895 $16K
86780 1,377 1,369 $16K
99307 2,307 1,572 $15K
17110 100 93 $15K
73630 374 325 $14K
86803 1,135 1,127 $14K
73562 342 314 $14K
99442 187 179 $14K
95811 13 13 $12K
90750 53 53 $12K
76536 93 91 $11K
64483 26 26 $11K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 57 57 $10K
84466 984 974 $10K
96127 1,387 1,340 $10K
76376 419 414 $10K
87340 1,064 1,058 $9K
99459 312 308 $9K
73610 237 216 $9K
76819 Fetal biophysical profile; without non-stress testing 103 80 $9K
88313 49 49 $9K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 16 16 $8K
J1030 Injection, methylprednisolone acetate, 40 mg 852 791 $8K
0002A 199 199 $8K
0001A 199 199 $8K
99223 Prolong inpt eval add15 m 98 81 $8K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 434 388 $7K
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) 159 145 $7K
81001 2,681 2,628 $7K
45380 Colonoscopy, flexible; with biopsy, single or multiple 26 26 $7K
99177 889 889 $6K
83540 1,080 1,070 $5K
90472 Immunization administration, each additional vaccine (list separately) 376 376 $5K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 58 52 $5K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 97 36 $5K
99308 Subsequent nursing facility care, per day, straightforward 203 95 $5K
90970 776 161 $5K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 15 14 $5K
88142 209 209 $4K
96110 Developmental screening, with scoring and documentation, per standardized instrument 292 292 $4K
84702 351 316 $4K
87081 743 740 $4K
81025 716 699 $4K
90480 96 96 $4K
72100 100 99 $4K
84439 523 517 $4K
31231 14 14 $4K
90620 26 26 $3K
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient 32 29 $3K
82607 293 288 $3K
83525 345 343 $3K
76801 26 25 $3K
92015 Determination of refractive state 178 178 $3K
S9083 Global fee urgent care centers 17 17 $3K
87428 89 88 $3K
83001 186 183 $3K
84153 190 188 $3K
90935 Hemodialysis procedure with single evaluation by a physician 83 41 $3K
83002 174 171 $3K
00811 43 43 $2K
84403 116 114 $2K
90651 86 86 $2K
0004A 58 58 $2K
86706 273 272 $2K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 12 12 $2K
93015 24 24 $2K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 81 81 $2K
88141 85 84 $2K
59025 Fetal non-stress test 35 25 $2K
82570 531 518 $2K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 256 244 $2K
81002 946 931 $2K
84146 130 129 $2K
86140 481 480 $2K
11102 14 13 $2K
95004 Percutaneous tests with allergenic extracts, immediate type reaction 12 12 $2K
83970 58 58 $2K
85651 529 525 $2K
82670 81 81 $2K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 18 18 $2K
82043 397 396 $2K
Q0091 Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory 45 45 $2K
99441 26 26 $1K
73130 39 26 $1K
85730 274 268 $1K
90662 80 73 $1K
85610 360 345 $1K
82746 84 84 $1K
92557 26 26 $1K
86708 116 115 $1K
86704 117 116 $1K
90671 38 38 $1K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 65 65 $1K
82550 296 292 $1K
90656 729 729 $1K
73030 31 30 $1K
99233 Prolong inpt eval add15 m 65 25 $1K
86850 118 117 $904.91
85018 431 431 $899.51
11900 12 12 $881.82
87088 126 125 $849.45
87086 Culture, bacterial; quantitative colony count, urine 126 125 $847.35
20552 13 13 $804.00
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) 343 244 $773.62
86480 16 16 $707.00
84270 39 38 $677.82
99051 73 72 $677.00
77063 Screening digital breast tomosynthesis, bilateral 13 13 $657.41
G0008 Administration of influenza virus vaccine 217 197 $609.00
72040 14 14 $542.64
0031A 16 16 $527.33
94060 12 12 $512.77
0124A 12 12 $480.00
0082A 12 12 $480.00
0072A 12 12 $480.00
0011A 12 12 $480.00
0081A 12 12 $480.00
J1100 Injection, dexamethasone sodium phosphate, 1 mg 344 317 $467.00
82627 26 26 $466.73
77080 12 12 $446.52
87070 67 67 $424.49
0012A 12 12 $414.85
84481 25 25 $350.61
83550 87 87 $345.44
82947 111 111 $342.26
77072 13 13 $341.83
90677 29 29 $313.77
86900 135 132 $313.74
86901 135 132 $313.74
86762 27 27 $310.77
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 17 17 $281.32
87481 13 13 $231.55
82948 55 55 $221.65
J1040 Injection, methylprednisolone acetate, 80 mg 15 15 $216.17
J1010 Injection, methylprednisolone acetate, 1 mg 26 26 $197.44
87511 13 13 $193.05
90734 78 78 $188.67
84144 13 12 $187.76
99000 16,744 15,404 $142.57
86376 12 12 $139.68
G0179 Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care 22 12 $119.34
90473 13 13 $117.85
84156 39 36 $111.72
84550 28 28 $95.56
86038 15 15 $73.50
83690 13 13 $73.01
83735 12 12 $60.03
86431 13 13 $59.02
82962 237 184 $51.00
85652 22 22 $38.38
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme 26 26 $13.22
36416 295 295 $9.20
3078F 1,358 1,228 $0.00
90633 72 72 $0.00
1160F 1,527 1,378 $0.00
90670 12 12 $0.00
1159F 1,527 1,378 $0.00
90648 29 29 $0.00
99001 13 13 $0.00
3725F 46 42 $0.00
1126F 468 443 $0.00
3074F 1,088 987 $0.00
3008F 1,645 1,487 $0.00
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 31 25 $0.00
3079F 13 12 $0.00
1036F 213 180 $0.00
1125F 14 14 $0.00
97010 342 152 $0.00
90680 18 18 $0.00
90723 18 18 $0.00
3075F 25 25 $0.00
2023F 25 25 $0.00