Physician
Westchester Medical Group, P.C.
Westchester Medical Group, P.C. was paid $16.09M by Medicaid between Jan 2018 and Dec 2024, across 240 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 27% of everything it billed.
33Billing provider infoWESTCHESTER MEDICAL GROUP, P.C.
RYE BROOK, NY 10573
RYE BROOK, NY 10573
33aNPI1881653822assigned 03/20/2006
33bProvider typePediatrics Physician
28Total paid$16.09M
24GClaims340,445
24DCodes billed240
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in New York
Rank by total paid#9 of 1,983
Median peer was paid$17K
This provider vs. median948×
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 | 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 | |
| 2024incomplete | 58,300 | $2.87M |
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 | 27% | 46,169 | 41,919 | $4.38M |
| 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 | 19% | 26,757 | 23,422 | $3.01M |
| 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 | 3.7% | 2,917 | 2,852 | $589K |
| 77067 | Screening mammography, bilateral, including computer-aided detection | 3.6% | 4,080 | 4,064 | $583K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 3.6% | 4,228 | 4,067 | $583K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 3.3% | 3,911 | 3,848 | $532K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 2.5% | 20,656 | 20,505 | $407K |
| 76641 | 2.2% | 3,152 | 2,019 | $361K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.0% | 2,165 | 2,162 | $317K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.9% | 2,298 | 2,298 | $308K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 1.9% | 4,855 | 1,829 | $307K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 1.6% | 2,290 | 2,250 | $264K |
228 more codes
| 76830 | Ultrasound, transvaginal | 1.6% | 1,987 | $252K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 1.5% | 1,595 | $234K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 1.4% | 1,401 | $219K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.2% | 1,476 | $198K |
| 88175 | Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer | 1.2% | 7,495 | $196K |
| 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | <1% | 4,335 | $154K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 4,446 | $143K |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 4,430 | $142K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 2,022 | $131K |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 3,785 | $122K |
| 92551 | <1% | 13,333 | $121K | |
| 90960 | End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits | <1% | 2,444 | $121K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 915 | $112K |
| 80061 | Lipid panel | <1% | 8,440 | $91K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 427 | $91K |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | <1% | 725 | $87K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 2,362 | $81K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 944 | $78K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 630 | $78K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 11,044 | $71K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 5,773 | $64K |
| 20611 | <1% | 501 | $61K | |
| 80050 | General health panel | <1% | 1,734 | $56K |
| 99385 | <1% | 341 | $55K | |
| 20610 | <1% | 690 | $55K | |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 606 | $54K |
| 88312 | <1% | 343 | $53K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 6,072 | $46K |
| 90961 | <1% | 1,479 | $46K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 1,886 | $45K |
| 36415 | Collection of venous blood by venipuncture | <1% | 25,981 | $43K |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 2,512 | $35K |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 4,299 | $34K |
| 73721 | Magnetic resonance imaging, any joint of lower extremity; without contrast material | <1% | 155 | $33K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 2,606 | $33K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 2,880 | $33K |
| 80053 | Comprehensive metabolic panel | <1% | 3,838 | $31K |
| J1756 | Injection, iron sucrose, 1 mg | <1% | 371 | $30K |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | <1% | 1,452 | $29K |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | <1% | 1,046 | $29K |
| 80076 | <1% | 3,711 | $28K | |
| 93000 | <1% | 1,622 | $27K | |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 115 | $27K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 163 | $26K |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 989 | $23K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 1,934 | $23K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 191 | $22K |
| 99386 | <1% | 109 | $20K | |
| 82728 | <1% | 1,780 | $20K | |
| 90715 | <1% | 423 | $19K | |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 58 | $19K |
| 99173 | <1% | 4,580 | $19K | |
| 70551 | Magnetic resonance imaging, brain; without contrast material | <1% | 81 | $17K |
| 90674 | <1% | 625 | $17K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 323 | $17K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 591 | $16K |
| 90686 | <1% | 1,897 | $16K | |
| 86780 | <1% | 1,377 | $16K | |
| 99307 | <1% | 2,307 | $15K | |
| 17110 | <1% | 100 | $15K | |
| 73630 | <1% | 374 | $14K | |
| 86803 | <1% | 1,135 | $14K | |
| 73562 | <1% | 342 | $14K | |
| 99442 | <1% | 187 | $14K | |
| 95811 | <1% | 13 | $12K | |
| 90750 | <1% | 53 | $12K | |
| 76536 | <1% | 93 | $11K | |
| 64483 | <1% | 26 | $11K | |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 57 | $10K |
| 84466 | <1% | 984 | $10K | |
| 96127 | <1% | 1,387 | $10K | |
| 76376 | <1% | 419 | $10K | |
| 87340 | <1% | 1,064 | $9K | |
| 99459 | <1% | 312 | $9K | |
| 73610 | <1% | 237 | $9K | |
| 76819 | Fetal biophysical profile; without non-stress testing | <1% | 103 | $9K |
| 88313 | <1% | 49 | $9K | |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | <1% | 16 | $8K |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 852 | $8K |
| 0002A | <1% | 199 | $8K | |
| 0001A | <1% | 199 | $8K | |
| 99223 | Prolong inpt eval add15 m | <1% | 98 | $8K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 434 | $7K |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 159 | $7K |
| 81001 | <1% | 2,681 | $7K | |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 26 | $7K |
| 99177 | <1% | 889 | $6K | |
| 83540 | <1% | 1,080 | $5K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 376 | $5K |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | <1% | 58 | $5K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 97 | $5K |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 203 | $5K |
| 90970 | <1% | 776 | $5K | |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | <1% | 15 | $5K |
| 88142 | <1% | 209 | $4K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 292 | $4K |
| 84702 | <1% | 351 | $4K | |
| 87081 | <1% | 743 | $4K | |
| 81025 | <1% | 716 | $4K | |
| 90480 | <1% | 96 | $4K | |
| 72100 | <1% | 100 | $4K | |
| 84439 | <1% | 523 | $4K | |
| 31231 | <1% | 14 | $4K | |
| 90620 | <1% | 26 | $3K | |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | <1% | 32 | $3K |
| 82607 | <1% | 293 | $3K | |
| 83525 | <1% | 345 | $3K | |
| 76801 | <1% | 26 | $3K | |
| 92015 | Determination of refractive state | <1% | 178 | $3K |
| S9083 | Global fee urgent care centers | <1% | 17 | $3K |
| 87428 | <1% | 89 | $3K | |
| 83001 | <1% | 186 | $3K | |
| 84153 | <1% | 190 | $3K | |
| 90935 | Hemodialysis procedure with single evaluation by a physician | <1% | 83 | $3K |
| 83002 | <1% | 174 | $3K | |
| 00811 | <1% | 43 | $2K | |
| 84403 | <1% | 116 | $2K | |
| 90651 | <1% | 86 | $2K | |
| 0004A | <1% | 58 | $2K | |
| 86706 | <1% | 273 | $2K | |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | <1% | 12 | $2K |
| 93015 | <1% | 24 | $2K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 81 | $2K |
| 88141 | <1% | 85 | $2K | |
| 59025 | Fetal non-stress test | <1% | 35 | $2K |
| 82570 | <1% | 531 | $2K | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 256 | $2K |
| 81002 | <1% | 946 | $2K | |
| 84146 | <1% | 130 | $2K | |
| 86140 | <1% | 481 | $2K | |
| 11102 | <1% | 14 | $2K | |
| 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | <1% | 12 | $2K |
| 83970 | <1% | 58 | $2K | |
| 85651 | <1% | 529 | $2K | |
| 82670 | <1% | 81 | $2K | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 18 | $2K |
| 82043 | <1% | 397 | $2K | |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | <1% | 45 | $2K |
| 99441 | <1% | 26 | $1K | |
| 73130 | <1% | 39 | $1K | |
| 85730 | <1% | 274 | $1K | |
| 90662 | <1% | 80 | $1K | |
| 85610 | <1% | 360 | $1K | |
| 82746 | <1% | 84 | $1K | |
| 92557 | <1% | 26 | $1K | |
| 86708 | <1% | 116 | $1K | |
| 86704 | <1% | 117 | $1K | |
| 90671 | <1% | 38 | $1K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 65 | $1K |
| 82550 | <1% | 296 | $1K | |
| 90656 | <1% | 729 | $1K | |
| 73030 | <1% | 31 | $1K | |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 65 | $1K |
| 86850 | <1% | 118 | $904.91 | |
| 85018 | <1% | 431 | $899.51 | |
| 11900 | <1% | 12 | $881.82 | |
| 87088 | <1% | 126 | $849.45 | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 126 | $847.35 |
| 20552 | <1% | 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) | <1% | 343 | $773.62 |
| 86480 | <1% | 16 | $707.00 | |
| 84270 | <1% | 39 | $677.82 | |
| 99051 | <1% | 73 | $677.00 | |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 13 | $657.41 |
| G0008 | Administration of influenza virus vaccine | <1% | 217 | $609.00 |
| 72040 | <1% | 14 | $542.64 | |
| 0031A | <1% | 16 | $527.33 | |
| 94060 | <1% | 12 | $512.77 | |
| 0124A | <1% | 12 | $480.00 | |
| 0082A | <1% | 12 | $480.00 | |
| 0072A | <1% | 12 | $480.00 | |
| 0011A | <1% | 12 | $480.00 | |
| 0081A | <1% | 12 | $480.00 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 344 | $467.00 |
| 82627 | <1% | 26 | $466.73 | |
| 77080 | <1% | 12 | $446.52 | |
| 87070 | <1% | 67 | $424.49 | |
| 0012A | <1% | 12 | $414.85 | |
| 84481 | <1% | 25 | $350.61 | |
| 83550 | <1% | 87 | $345.44 | |
| 82947 | <1% | 111 | $342.26 | |
| 77072 | <1% | 13 | $341.83 | |
| 90677 | <1% | 29 | $313.77 | |
| 86900 | <1% | 135 | $313.74 | |
| 86901 | <1% | 135 | $313.74 | |
| 86762 | <1% | 27 | $310.77 | |
| 87661 | Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe | <1% | 17 | $281.32 |
| 87481 | <1% | 13 | $231.55 | |
| 82948 | <1% | 55 | $221.65 | |
| J1040 | Injection, methylprednisolone acetate, 80 mg | <1% | 15 | $216.17 |
| J1010 | Injection, methylprednisolone acetate, 1 mg | <1% | 26 | $197.44 |
| 87511 | <1% | 13 | $193.05 | |
| 90734 | <1% | 78 | $188.67 | |
| 84144 | <1% | 13 | $187.76 | |
| 99000 | <1% | 16,744 | $142.57 | |
| 86376 | <1% | 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 | <1% | 22 | $119.34 |
| 90473 | <1% | 13 | $117.85 | |
| 84156 | <1% | 39 | $111.72 | |
| 84550 | <1% | 28 | $95.56 | |
| 86038 | <1% | 15 | $73.50 | |
| 83690 | <1% | 13 | $73.01 | |
| 83735 | <1% | 12 | $60.03 | |
| 86431 | <1% | 13 | $59.02 | |
| 82962 | <1% | 237 | $51.00 | |
| 85652 | <1% | 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 | <1% | 26 | $13.22 |
| 36416 | <1% | 295 | $9.20 | |
| 3078F | 0% | 1,358 | $0.00 | |
| 90633 | 0% | 72 | $0.00 | |
| 1160F | 0% | 1,527 | $0.00 | |
| 90670 | 0% | 12 | $0.00 | |
| 1159F | 0% | 1,527 | $0.00 | |
| 90648 | 0% | 29 | $0.00 | |
| 99001 | 0% | 13 | $0.00 | |
| 3725F | 0% | 46 | $0.00 | |
| 1126F | 0% | 468 | $0.00 | |
| 3074F | 0% | 1,088 | $0.00 | |
| 3008F | 0% | 1,645 | $0.00 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 31 | $0.00 |
| 3079F | 0% | 13 | $0.00 | |
| 1036F | 0% | 213 | $0.00 | |
| 1125F | 0% | 14 | $0.00 | |
| 97010 | 0% | 342 | $0.00 | |
| 90680 | 0% | 18 | $0.00 | |
| 90723 | 0% | 18 | $0.00 | |
| 3075F | 0% | 25 | $0.00 | |
| 2023F | 0% | 25 | $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 (DIRECTOR OF ENROLLMENT)
| Provider | Location | 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 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.