NP / PA
Encina Pediatrics and Primary Care
Encina Pediatrics and Primary Care was paid $620K by Medicaid between Apr 2021 and Dec 2024, across 21 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 83% of everything it billed.
33Billing provider infoENCINA PEDIATRICS AND PRIMARY CARE
UVALDE, TX 78801
UVALDE, TX 78801
33aNPI1073882023assigned 12/20/2011
33bProvider typePediatric Nurse Practitioner
28Total paid$620K
24GClaims16,426
24DCodes billed21
24AFirst – last monthApr 2021 – Dec 2024
Compared with peers
Next to other Pediatric Nurse Practitioner providers in Texas
Rank by total paid#10 of 51
Median peer was paid$10K
This provider vs. median63×
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 | |
|---|---|---|---|
| 2021 | 56 | $2K | |
| 2022 | 4,816 | $160K | |
| 2023 | 5,942 | $212K | |
| 2024incomplete | 5,612 | $246K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 83% | 7,283 | 5,328 | $514K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 6.9% | 514 | 498 | $43K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.6% | 358 | 342 | $28K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.2% | 272 | 261 | $20K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.1% | 85 | 83 | $7K |
| 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 | <1% | 2,042 | 1,776 | $5K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 3,698 | 3,074 | $2K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 868 | 397 | $441.57 |
| 92552 | <1% | 296 | 292 | $369.32 | |
| 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% | 15 | 15 | $65.25 |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 48 | 48 | $16.28 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 221 | 205 | $13.89 |
9 more codes
| 90630 | <1% | 13 | $0.06 | |
| 96160 | 0% | 101 | $0.00 | |
| 90670 | 0% | 84 | $0.00 | |
| 99173 | 0% | 314 | $0.00 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 0% | 62 | $0.00 |
| 90710 | 0% | 12 | $0.00 | |
| 90650 | 0% | 114 | $0.00 | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 0% | 13 | $0.00 |
| 90647 | 0% | 13 | $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 officialGUERRERO, ROY (MD/OWNER)