Physician
Sanchez, Arlene
Sanchez, Arlene was paid $1.26M by Medicaid between Nov 2020 and Dec 2024, across 38 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 24% of everything it billed.
33Billing provider infoSANCHEZ, ARLENE
EDINBURG, TX 78539
EDINBURG, TX 78539
33aNPI1235235409assigned 09/15/2006
33bProvider typePediatrics Physician
28Total paid$1.26M
24GClaims46,813
24DCodes billed38
24AFirst – last monthNov 2020 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Texas
Rank by total paid#333 of 1,136
Median peer was paid$329K
This provider vs. median3.8×
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 | |
|---|---|---|---|
| 2020 | 1,164 | $29K | |
| 2021 | 9,434 | $251K | |
| 2022 | 14,907 | $383K | |
| 2023 | 11,675 | $319K | |
| 2024incomplete | 9,633 | $276K |
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 | 24% | 8,263 | 7,121 | $302K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 12% | 3,423 | 3,088 | $146K |
| 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 | 12% | 2,789 | 2,593 | $145K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 8.0% | 1,278 | 1,267 | $101K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 7.0% | 6,574 | 2,956 | $88K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 6.6% | 1,101 | 1,027 | $84K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 6.4% | 981 | 972 | $80K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 5.9% | 5,441 | 4,896 | $74K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 5.1% | 716 | 711 | $64K |
| 99429 | 2.7% | 1,087 | 1,080 | $34K | |
| 99241 | 2.7% | 900 | 850 | $34K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.8% | 926 | 881 | $23K |
26 more codes
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.7% | 2,153 | $21K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 1.2% | 1,773 | $15K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.1% | 1,647 | $13K |
| 87807 | <1% | 888 | $9K | |
| 99000 | <1% | 840 | $9K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 670 | $4K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 410 | $4K |
| 90474 | <1% | 216 | $2K | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 41 | $1K |
| 96161 | <1% | 508 | $1K | |
| 99358 | Prolong nursin fac eval 15m | <1% | 53 | $990.00 |
| G9716 | Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason | <1% | 1,503 | $660.00 |
| 90619 | <1% | 36 | $0.09 | |
| 90686 | <1% | 394 | $0.07 | |
| 90620 | <1% | 42 | $0.01 | |
| 90697 | 0% | 260 | $0.00 | |
| 90744 | 0% | 16 | $0.00 | |
| 36415 | Collection of venous blood by venipuncture | 0% | 481 | $0.00 |
| 90698 | 0% | 164 | $0.00 | |
| 90680 | 0% | 229 | $0.00 | |
| 90651 | 0% | 28 | $0.00 | |
| 90633 | 0% | 133 | $0.00 | |
| 90670 | 0% | 552 | $0.00 | |
| 90671 | 0% | 156 | $0.00 | |
| 90710 | 0% | 95 | $0.00 | |
| 90734 | 0% | 46 | $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.