Physician
Clinica Del Norte Pediatrics PLLC
Clinica Del Norte Pediatrics PLLC was paid $4.08M by Medicaid between Feb 2018 and Dec 2024, across 63 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 18% of everything it billed.
33Billing provider infoCLINICA DEL NORTE PEDIATRICS PLLC
SAN ANTONIO, TX 78201
SAN ANTONIO, TX 78201
33aNPI1144350380assigned 03/06/2007
33bProvider typePediatrics Physician
28Total paid$4.08M
24GClaims153,713
24DCodes billed63
24AFirst – last monthFeb 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Texas
Rank by total paid#111 of 1,136
Median peer was paid$329K
This provider vs. median12×
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 | 84 | $2K | |
| 2019 | 159 | $5K | |
| 2020 | 8,449 | $188K | |
| 2021 | 37,469 | $966K | |
| 2022 | 42,288 | $1.17M | |
| 2023 | 35,326 | $928K | |
| 2024incomplete | 29,938 | $817K |
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 | 18% | 21,726 | 19,725 | $738K |
| 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 | 15% | 12,990 | 12,238 | $620K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 11% | 5,773 | 5,627 | $449K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 11% | 5,853 | 5,816 | $445K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 7.9% | 4,448 | 4,412 | $322K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 7.9% | 7,626 | 7,325 | $322K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 4.6% | 15,011 | 6,746 | $187K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.3% | 2,507 | 2,466 | $173K |
| 96156 | 2.9% | 3,020 | 3,002 | $120K | |
| 99429 | 2.6% | 3,636 | 3,588 | $106K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.8% | 3,176 | 3,102 | $73K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.7% | 4,573 | 2,816 | $69K |
51 more codes
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.7% | 4,976 | $68K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 1.5% | 7,615 | $60K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 1.4% | 701 | $56K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.3% | 6,465 | $54K |
| 99381 | <1% | 515 | $38K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 434 | $32K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 4,016 | $30K |
| 99000 | <1% | 2,766 | $25K | |
| 99383 | <1% | 287 | $23K | |
| 99384 | <1% | 183 | $17K | |
| 0071A | <1% | 325 | $13K | |
| 83655 | <1% | 961 | $10K | |
| 99382 | <1% | 105 | $8K | |
| 90461 | <1% | 1,582 | $5K | |
| 0001A | <1% | 98 | $4K | |
| 96160 | <1% | 1,049 | $2K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 233 | $1K |
| 90473 | <1% | 510 | $1K | |
| 90474 | <1% | 112 | $1K | |
| 82570 | <1% | 165 | $622.02 | |
| 85018 | <1% | 825 | $595.84 | |
| 0111A | <1% | 12 | $480.00 | |
| 81003 | <1% | 184 | $255.46 | |
| 92587 | <1% | 12 | $151.02 | |
| 90688 | <1% | 5,354 | $148.96 | |
| 90633 | <1% | 1,686 | $74.75 | |
| 84030 | <1% | 14 | $71.82 | |
| 90707 | <1% | 1,791 | $44.85 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 12 | $31.77 |
| 90670 | <1% | 2,629 | $29.90 | |
| 90716 | <1% | 1,799 | $29.90 | |
| 90715 | <1% | 1,160 | $14.96 | |
| 90713 | <1% | 741 | $14.95 | |
| 90746 | <1% | 35 | $14.95 | |
| 90723 | <1% | 782 | $14.95 | |
| 90620 | <1% | 1,590 | $14.95 | |
| 90680 | <1% | 1,457 | $14.95 | |
| 91307 | <1% | 355 | $0.22 | |
| 90697 | <1% | 533 | $0.19 | |
| 90380 | <1% | 25 | $0.02 | |
| 90734 | <1% | 2,060 | $0.01 | |
| 90651 | <1% | 2,296 | $0.01 | |
| 90700 | 0% | 1,537 | $0.00 | |
| 90687 | 0% | 360 | $0.00 | |
| 90681 | 0% | 14 | $0.00 | |
| 91300 | 0% | 104 | $0.00 | |
| 91311 | 0% | 12 | $0.00 | |
| 90647 | 0% | 2,021 | $0.00 | |
| 90696 | 0% | 829 | $0.00 | |
| 96127 | 0% | 15 | $0.00 | |
| 99495 | 0% | 32 | $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 officialSANCHEZ, EDUARDO (MANAGING MEMBER)