Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › NJ › BERKELEY HEIGHTS › SUMMIT MEDICAL GROUP PA

SUMMIT MEDICAL GROUP PA

NPI: 1942254347 · BERKELEY HEIGHTS, NJ 07922 · Multi-Specialty Clinic/Center · NPI assigned 05/20/2006

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

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

$6.74M
Total Medicaid Paid
335,132
Total Claims
310,233
Beneficiaries
142
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialHENRY, SWAHILI (DIRECTOR PROVIDER ENROLLMENT)
NPI Enumeration Date05/20/2006

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
WESTCHESTER MEDICAL GROUP, P.C. RYE BROOK NY $16.09M
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 1,590 $30K
2019 825 $28K
2020 885 $27K
2021 24,518 $1.05M
2022 115,919 $2.00M
2023 89,901 $2.08M
2024 101,494 $1.52M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 31,145 27,693 $1.51M
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 17,536 17,250 $1.13M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 33,085 29,177 $1.12M
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 4,711 4,405 $465K
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 14,570 14,389 $311K
76857 8,345 7,350 $282K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 15,252 14,925 $233K
76775 2,835 2,530 $151K
88120 1,800 1,347 $151K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 15,230 14,902 $125K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 1,704 1,611 $113K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 10,261 10,137 $109K
51798 7,960 7,041 $83K
G6015 Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session 934 167 $74K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 8,545 8,460 $67K
76872 1,185 1,057 $63K
87340 9,536 9,438 $62K
51741 4,187 3,683 $61K
86803 9,487 9,391 $60K
87070 19,421 19,259 $50K
86780 9,114 9,017 $48K
87631 2,678 2,663 $46K
99232 Subsequent hospital care, per day, moderate complexity 2,799 1,568 $37K
52000 287 259 $34K
87088 10,802 10,390 $28K
87086 Culture, bacterial; quantitative colony count, urine 10,215 9,843 $28K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 1,142 1,034 $27K
87510 2,905 2,843 $27K
77014 913 164 $26K
87660 2,661 2,609 $24K
86480 813 812 $20K
87480 2,907 2,844 $14K
86696 1,222 1,207 $10K
76705 Ultrasound, abdominal, real time with image documentation; limited 139 118 $10K
36415 Collection of venous blood by venipuncture 8,418 7,617 $10K
51701 424 378 $9K
87077 3,139 2,933 $9K
99223 Prolong inpt eval add15 m 150 136 $8K
87186 3,404 3,091 $8K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 958 944 $8K
88108 2,503 1,866 $7K
51728 85 70 $6K
52281 50 40 $6K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 209 197 $5K
84153 4,139 3,478 $5K
99231 Subsequent hospital care, per day, straightforward or low complexity 611 370 $5K
95813 56 54 $5K
81003 15,132 12,586 $4K
99222 Initial hospital care, per day, moderate complexity 171 150 $4K
87428 191 190 $3K
86695 1,225 1,210 $3K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 25 12 $3K
76770 143 116 $3K
80053 Comprehensive metabolic panel 1,964 1,849 $2K
52315 91 71 $2K
86706 313 312 $2K
84403 741 557 $1K
86762 305 303 $1K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 123 103 $1K
51700 20 12 $1K
87205 623 615 $1K
86765 283 281 $1K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 91 85 $1K
99215 Prolong outpt/office vis 68 64 $988.14
84154 977 790 $972.23
85025 Blood count; complete (CBC), automated, and automated differential WBC count 2,056 1,940 $959.71
99308 Subsequent nursing facility care, per day, straightforward 271 157 $930.10
84702 154 154 $923.30
77067 Screening mammography, bilateral, including computer-aided detection 67 67 $911.00
86769 67 67 $900.64
83036 Hemoglobin; glycosylated (A1C) 742 732 $841.09
70551 Magnetic resonance imaging, brain; without contrast material 14 14 $840.62
84270 438 318 $813.22
86735 294 292 $775.76
84443 Thyroid stimulating hormone (TSH) 800 789 $765.27
86592 322 314 $751.22
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 53 51 $726.03
80061 Lipid panel 846 837 $614.65
77063 Screening digital breast tomosynthesis, bilateral 51 51 $573.83
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 184 179 $540.50
87147 1,056 1,052 $458.73
99233 Prolong inpt eval add15 m 45 25 $447.53
86787 146 146 $380.77
80048 Basic metabolic panel (calcium, ionized) 431 396 $377.50
71045 Radiologic examination, chest; single view 173 160 $375.06
93000 116 99 $331.03
87481 25 25 $315.75
83550 161 157 $307.52
81002 1,195 1,011 $302.01
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) 280 259 $290.99
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 84 84 $290.40
76700 Ultrasound, abdominal, real time with image documentation; complete 16 15 $290.25
83540 166 162 $272.62
87511 25 25 $263.25
82728 184 180 $248.01
71046 Radiologic examination, chest; 2 views 82 82 $231.33
86618 31 31 $204.36
76642 12 12 $180.26
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 13 13 $173.61
82040 389 280 $171.39
82607 129 126 $148.04
81001 539 512 $147.61
82565 223 158 $132.96
80076 56 55 $125.26
70450 Computed tomography, head or brain; without contrast material 12 12 $115.14
82570 122 118 $112.60
84520 219 159 $107.99
84439 99 98 $91.17
82746 75 73 $84.91
87324 17 17 $75.92
86593 40 40 $70.50
82043 92 88 $70.14
J1580 Injection, garamycin, gentamicin, up to 80 mg 114 108 $63.50
84550 49 44 $60.86
87449 17 17 $51.58
86140 86 84 $44.47
86038 41 41 $42.00
83002 19 12 $34.00
83735 51 45 $33.18
31231 16 16 $30.00
83690 16 16 $29.05
85652 81 79 $26.67
85027 25 25 $18.98
20610 22 14 $16.58
84100 34 29 $8.72
85610 32 28 $7.38
85730 12 12 $6.01
83014 25 25 $1.57
3074F 670 647 $0.00
1036F 2,236 1,852 $0.00
3044F 159 155 $0.00
3008F 748 677 $0.00
3079F 139 133 $0.00
1101F 58 58 $0.00
99429 957 784 $0.00
1160F 1,040 922 $0.00
3725F 675 636 $0.00
99080 133 128 $0.00
1159F 1,024 907 $0.00
3288F 440 438 $0.00
3078F 554 521 $0.00
S9083 Global fee urgent care centers 89 85 $0.00