San Benito Medical Associates, PLLC

San Benito Medical Associates, PLLC was paid $1.77M by Medicaid between Jan 2018 and May 2024, across 73 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 38% of everything it billed.

33Billing provider infoSAN BENITO MEDICAL ASSOCIATES, PLLC
SAN BENITO, TX 78586

33aNPI1093792624assigned 12/23/2005

33bProvider typeFamily Medicine Physician

28Total paid$1.77M

24GClaims84,612

24DCodes billed73

24AFirst – last monthJan 2018 – May 2024

Compared with peers

Next to other Family Medicine Physician providers in Texas

Rank by total paid#64 of 1,204

Median peer was paid$31K

This provider vs. median57×

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
2018	12,091	$117K
2019	9,813	$112K
2020	7,589	$134K
2021	20,699	$503K
2022	24,527	$608K
2023	9,705	$288K
2024incomplete	188	$5K

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	38%	25,784	23,086	$679K
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	20%	12,258	11,231	$354K
99091		12%	2,724	2,629	$215K
87635	Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe	7.5%	2,967	2,835	$133K
99423		6.7%	2,078	801	$119K
99444		5.9%	1,835	436	$104K
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	2.0%	2,910	1,406	$36K
99422		1.6%	1,268	667	$28K
99000		1.2%	2,058	1,979	$21K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	<1%	190	178	$14K
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	1,735	1,562	$12K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	<1%	917	884	$11K

61 more codes

85025	Blood count; complete (CBC), automated, and automated differential WBC count	<1%	4,834	$10K
99308	Subsequent nursing facility care, per day, straightforward	<1%	1,734	$9K
80053	Comprehensive metabolic panel	<1%	3,388	$3K
81001		<1%	2,407	$3K
90686		<1%	334	$3K
83036	Hemoglobin; glycosylated (A1C)	<1%	877	$2K
99490	Ccm add 20min	<1%	1,111	$2K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	78	$2K
90460	Immunization administration through 18 years of age via any route, first or only component	<1%	123	$970.13
99421		<1%	46	$822.48
84443	Thyroid stimulating hormone (TSH)	<1%	986	$706.31
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	58	$672.78
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	<1%	13	$580.45
93923		<1%	33	$458.22
99441		<1%	65	$351.68
80061	Lipid panel	<1%	702	$339.99
J1040	Injection, methylprednisolone acetate, 80 mg	<1%	68	$292.74
96161		<1%	119	$258.44
99439		<1%	459	$239.27
J1885	Injection, ketorolac tromethamine, per 15 mg	<1%	263	$232.14
99307		<1%	230	$216.80
99457		<1%	880	$208.39
0012A		<1%	37	$208.00
99454		<1%	670	$204.45
99051		<1%	68	$194.22
93922		<1%	13	$137.61
90461		<1%	20	$135.27
0011A		<1%	49	$130.82
83721		<1%	206	$73.19
99458		<1%	603	$72.10
82044		<1%	241	$70.44
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	<1%	22	$45.30
99453		<1%	53	$37.37
82274		<1%	24	$36.66
82570		<1%	73	$36.24
90688		<1%	40	$33.62
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%	75	$23.30
91301		<1%	164	$0.04
G8510	Screening for depression is documented as negative, a follow-up plan is not required	<1%	49	$0.03
G0442	Annual alcohol misuse screening, 5 to 15 minutes	0%	605	$0.00
G0008	Administration of influenza virus vaccine	0%	596	$0.00
1170F		0%	659	$0.00
1036F		0%	403	$0.00
G8754	Most recent diastolic blood pressure < 90 mmhg	0%	565	$0.00
1126F		0%	148	$0.00
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	0%	544	$0.00
1125F		0%	66	$0.00
96127		0%	23	$0.00
3074F		0%	16	$0.00
1101F		0%	133	$0.00
36415	Collection of venous blood by venipuncture	0%	42	$0.00
1111F		0%	67	$0.00
G0444	Annual depression screening, 5 to 15 minutes	0%	634	$0.00
90662		0%	306	$0.00
3725F		0%	478	$0.00
G8417	Bmi is documented above normal parameters and a follow-up plan is documented	0%	224	$0.00
G8752	Most recent systolic blood pressure < 140 mmhg	0%	456	$0.00
1159F		0%	361	$0.00
1100F		0%	62	$0.00
1160F		0%	270	$0.00
3078F		0%	15	$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 officialSCHACHERL, NORMA (PRESIDENT)