Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
Home › NY › Middletown › NPI 1902855828
Physician

Middletown Medical PC

Middletown Medical PC was paid $49.28M by Medicaid between Jan 2018 and Dec 2024, across 308 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 39% of everything it billed.

33Billing provider infoMIDDLETOWN MEDICAL PC
MIDDLETOWN, NY 10940
33aNPI1902855828assigned 05/08/2006
33bProvider typeFamily Medicine Physician
28Total paid$49.28M
24GClaims934,777
24DCodes billed308
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Family Medicine Physician providers in New York

Rank by total paid#2 of 2,605
Median peer was paid$10K
This provider vs. median4,880×

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

$0$500K$1.0M$1.5M2018201920202021202220232024
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
YearClaimsPaid
201859,997$3.00M
201972,591$3.51M
202081,964$4.94M
2021133,552$8.72M
2022172,844$10.28M
2023250,902$11.25M
2024incomplete162,927$7.58M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
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 39% 156,362 142,159 $19.12M
S9083 Global fee urgent care centers 14% 51,057 49,354 $6.77M
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 8.9% 52,191 48,977 $4.41M
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 4.3% 11,779 11,727 $2.13M
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 3.4% 23,825 23,107 $1.68M
J0585 Injection, onabotulinumtoxina, 1 unit 1.9% 1,571 789 $920K
99203 Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity 1.8% 7,254 7,226 $870K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 1.7% 4,381 4,369 $829K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 1.7% 16,237 15,991 $826K
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) 1.4% 24,052 23,570 $699K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 1.2% 14,346 13,947 $614K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) <1% 5,047 5,039 $491K
296 more codes
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion <1% 9,362 $423K
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% 21,920 $407K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe <1% 19,645 $378K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) <1% 3,901 $366K
36475 <1% 226 $338K
90460 Immunization administration through 18 years of age via any route, first or only component <1% 15,962 $317K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years <1% 2,593 $305K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) <1% 2,926 $289K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) <1% 2,985 $269K
99497 <1% 3,629 $260K
37241 <1% 42 $253K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple <1% 814 $214K
G2066 Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results <1% 1,644 $204K
87634 <1% 5,555 $196K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years <1% 1,620 $182K
64615 <1% 994 $174K
99215 Doctor's office visit, returning patient (complex) <1% 866 $167K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed <1% 7,831 $160K
80061 Lipid panel <1% 15,525 $136K
93000 <1% 8,717 $131K
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 28,407 $130K
93970 <1% 617 $124K
84443 Thyroid stimulating hormone (TSH) <1% 10,790 $123K
83036 Hemoglobin; glycosylated (A1C) <1% 17,151 $121K
93971 <1% 1,040 $120K
99051 <1% 8,495 $117K
97799 <1% 2,066 $102K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type <1% 12,892 $99K
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) <1% 1,304 $98K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 1,808 $97K
99232 Hospital visit by a doctor, follow-up day <1% 1,137 $87K
36415 Collection of venous blood by venipuncture <1% 51,633 $84K
A4550 Surgical trays <1% 303 $84K
80053 Comprehensive metabolic panel <1% 10,932 $83K
82607 <1% 7,983 $83K
99441 <1% 1,512 $81K
86618 <1% 6,452 $80K
G0101 Cervical or vaginal cancer screening; pelvic and clinical breast examination <1% 3,097 $77K
99233 Hospital visit by a doctor, follow-up day (complex) <1% 590 $76K
99442 <1% 696 $68K
93880 <1% 357 $68K
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% 4,035 $68K
99205 Prolong outpt/office vis <1% 259 $64K
82746 <1% 6,271 $64K
93298 <1% 1,902 $63K
90792 Psychiatric diagnostic evaluation with medical services <1% 301 $61K
92587 <1% 3,099 $59K
99223 Prolong inpt eval add15 m <1% 282 $58K
95816 <1% 130 $58K
Q0091 Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory <1% 3,446 $57K
95886 <1% 246 $54K
99406 <1% 3,352 $49K
99443 <1% 380 $49K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 3,530 $48K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) <1% 165 $47K
80048 Basic metabolic panel (calcium, ionized) <1% 7,633 $46K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) <1% 1,844 $46K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 6,305 $46K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination <1% 1,231 $45K
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 825 $43K
76830 Ultrasound, transvaginal <1% 371 $43K
93015 <1% 605 $43K
97161 <1% 509 $41K
92250 <1% 1,155 $41K
80050 General health panel <1% 2,086 $41K
93923 <1% 314 $40K
90461 <1% 1,609 $36K
70551 Magnetic resonance imaging, brain; without contrast material <1% 151 $36K
96127 <1% 6,334 $36K
82977 <1% 7,094 $36K
95812 <1% 90 $35K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only <1% 3,697 $34K
81002 <1% 16,911 $33K
G0447 Face-to-face behavioral counseling for obesity, 15 minutes <1% 1,262 $32K
45380 Colonoscopy, flexible; with biopsy, single or multiple <1% 105 $32K
0011A <1% 803 $30K
80076 <1% 5,201 $30K
83615 <1% 7,080 $30K
37252 <1% 27 $29K
0012A <1% 739 $28K
99173 <1% 8,178 $28K
92551 <1% 5,333 $27K
84439 <1% 4,209 $26K
84436 <1% 5,116 $25K
96111 <1% 167 $23K
84479 <1% 5,010 $23K
96110 Developmental screening, with scoring and documentation, per standardized instrument <1% 2,541 $23K
36011 <1% 38 $22K
99498 <1% 355 $22K
90674 <1% 817 $21K
0001A <1% 525 $21K
80305 <1% 2,622 $21K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 266 $21K
93925 <1% 74 $19K
99239 Hospital discharge day management, more than 30 minutes <1% 168 $19K
0002A <1% 453 $18K
86160 <1% 1,005 $18K
64400 <1% 113 $18K
36416 <1% 5,572 $17K
11721 <1% 423 $17K
71046 Radiologic examination, chest; 2 views <1% 917 $17K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient <1% 129 $17K
20553 <1% 358 $16K
94729 <1% 244 $15K
84550 <1% 4,668 $15K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 1,511 $15K
94726 <1% 244 $15K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress <1% 37 $14K
83655 <1% 1,475 $13K
L3000 Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each <1% 48 $13K
99385 <1% 88 $13K
94060 <1% 268 $13K
95819 <1% 27 $12K
80074 <1% 490 $12K
96112 <1% 81 $11K
82044 <1% 2,923 $11K
93241 <1% 36 $10K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg <1% 1,618 $10K
86225 <1% 962 $10K
0013A <1% 242 $9K
86617 <1% 745 $9K
84481 <1% 705 $9K
83550 <1% 1,518 $8K
77067 Screening mammography, bilateral, including computer-aided detection <1% 64 $8K
4124F <1% 435 $8K
86140 <1% 2,091 $8K
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring <1% 13 $7K
64405 <1% 123 $7K
85651 <1% 2,587 $7K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 292 $7K
82728 <1% 759 $7K
93229 <1% 12 $7K
83540 <1% 1,506 $6K
81025 <1% 2,021 $6K
82962 <1% 2,839 $6K
80047 <1% 1,220 $6K
20610 <1% 86 $6K
86317 <1% 625 $5K
87428 <1% 326 $5K
92134 <1% 150 $5K
93299 <1% 38 $5K
90688 <1% 1,207 $5K
86769 <1% 162 $5K
93224 <1% 56 $5K
64450 <1% 104 $5K
99493 <1% 67 $5K
99050 <1% 321 $5K
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg <1% 1,764 $4K
G0283 Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care <1% 370 $4K
73562 <1% 152 $4K
97014 <1% 666 $4K
11102 <1% 41 $4K
90620 <1% 110 $4K
92133 <1% 111 $4K
87807 <1% 522 $4K
99384 <1% 32 $4K
74177 Computed tomography, abdomen and pelvis; with contrast material <1% 13 $4K
90836 <1% 35 $4K
71250 <1% 24 $4K
73630 <1% 132 $4K
94727 <1% 202 $3K
84153 <1% 289 $3K
A9502 Technetium tc-99m tetrofosmin, diagnostic, per study dose <1% 26 $3K
85018 <1% 1,931 $3K
96160 <1% 1,429 $3K
0003A <1% 82 $3K
88342 <1% 100 $3K
77063 Screening digital breast tomosynthesis, bilateral <1% 51 $3K
97803 <1% 361 $3K
99446 <1% 213 $2K
31231 <1% 12 $2K
97802 <1% 24 $2K
86235 <1% 54 $2K
90686 <1% 1,716 $2K
90697 <1% 41 $2K
95700 <1% 12 $2K
91322 <1% 16 $2K
99222 Initial hospital care, per day, moderate complexity <1% 14 $2K
0071A <1% 63 $2K
72148 Magnetic resonance imaging, lumbar spine; without contrast material <1% 12 $2K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient <1% 15 $2K
99177 <1% 446 $2K
0052A <1% 48 $2K
92002 <1% 26 $2K
83735 <1% 440 $2K
0072A <1% 43 $2K
86038 <1% 235 $2K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies <1% 159 $2K
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) <1% 409 $2K
0054A <1% 39 $2K
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient <1% 28 $2K
76536 <1% 13 $2K
83970 <1% 44 $2K
99459 <1% 64 $1K
99382 <1% 13 $1K
91320 <1% 13 $1K
0004A <1% 28 $1K
82043 <1% 275 $1K
72100 <1% 42 $1K
90651 <1% 229 $996.26
0134A <1% 26 $991.63
99383 <1% 13 $962.30
0051A <1% 21 $866.16
86200 <1% 79 $856.25
82570 <1% 262 $846.44
82550 <1% 303 $838.04
86703 <1% 137 $836.92
G0442 Annual alcohol misuse screening, 5 to 15 minutes <1% 53 $791.64
73130 <1% 34 $790.89
86431 <1% 194 $789.84
0031A <1% 15 $596.60
96161 <1% 196 $563.56
77080 <1% 15 $522.53
95012 <1% 24 $503.63
99401 <1% 25 $502.11
92557 <1% 12 $499.41
90661 <1% 131 $486.81
90480 <1% 29 $475.00
92563 <1% 12 $421.77
93244 <1% 20 $419.79
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 364 $414.99
95117 <1% 38 $412.60
90734 <1% 488 $393.51
A9576 Injection, gadoteridol, (prohance multipack), per ml <1% 15 $374.50
J1040 Injection, methylprednisolone acetate, 80 mg <1% 28 $342.66
93228 <1% 17 $318.71
86580 <1% 45 $270.67
82947 <1% 122 $267.45
G0444 Annual depression screening, 5 to 15 minutes <1% 26 $258.00
84484 <1% 78 $255.55
86706 <1% 26 $239.35
84100 <1% 66 $234.08
97010 <1% 392 $233.18
73610 <1% 13 $231.91
88112 <1% 12 $229.83
93242 <1% 20 $223.82
83874 <1% 89 $204.13
86376 <1% 28 $196.56
82553 <1% 77 $190.73
73030 <1% 12 $186.06
88313 <1% 13 $171.38
85027 <1% 39 $159.20
T1013 Sign language or oral interpretive services, per 15 minutes <1% 13 $155.21
82465 <1% 51 $151.13
85610 <1% 48 $137.36
84460 <1% 37 $136.50
J1030 Injection, methylprednisolone acetate, 40 mg <1% 15 $130.40
86701 <1% 12 $113.88
86762 <1% 15 $108.00
J1010 Injection, methylprednisolone acetate, 1 mg <1% 16 $102.05
51798 <1% 14 $101.02
86735 <1% 15 $97.95
86765 <1% 15 $96.60
90715 <1% 74 $77.05
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 15 $63.96
84450 <1% 25 $61.41
90656 <1% 94 $56.75
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg <1% 13 $41.62
83690 <1% 12 $41.40
G8709 Uri episodes when the patient had competing diagnoses on or three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti, and acne) <1% 799 $17.50
83986 <1% 12 $14.32
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 12 $1.44
2001F 0% 1,404 $0.00
3008F 0% 16,036 $0.00
3080F 0% 140 $0.00
3074F 0% 828 $0.00
3079F 0% 475 $0.00
1125F 0% 31 $0.00
3044F 0% 844 $0.00
2010F 0% 451 $0.00
3075F 0% 208 $0.00
90698 0% 172 $0.00
2023F 0% 386 $0.00
1034F 0% 2,538 $0.00
1000F 0% 100 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 0% 61 $0.00
1031F 0% 12 $0.00
90744 0% 16 $0.00
1036F 0% 17 $0.00
91301 0% 66 $0.00
1160F 0% 22,276 $0.00
1159F 0% 22,302 $0.00
90670 0% 422 $0.00
G8511 Screening for depression documented as positive, follow-up plan not documented, reason not given 0% 785 $0.00
3077F 0% 237 $0.00
4120F 0% 93 $0.00
2014F 0% 322 $0.00
3210F 0% 352 $0.00
90633 0% 41 $0.00
3078F 0% 638 $0.00
3046F 0% 115 $0.00
1032F 0% 74 $0.00
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 0% 152 $0.00
3051F 0% 76 $0.00
90681 0% 27 $0.00
90655 0% 12 $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 officialGULATI, RAJAN (CEO)