Physician
Fernando J Otero MD PA
Fernando J Otero MD PA was paid $4.23M by Medicaid between Jan 2020 and Dec 2024, across 45 billing codes. Its largest line is 59409, Vaginal delivery only (with or without episiotomy and/or forceps) — 19% of everything it billed.
33Billing provider infoFERNANDO J OTERO MD PA
MCALLEN, TX 78501
MCALLEN, TX 78501
33aNPI1245703719assigned 01/08/2019
33bProvider typeObstetrics & Gynecology Physician
28Total paid$4.23M
24GClaims107,103
24DCodes billed45
24AFirst – last monthJan 2020 – Dec 2024
Compared with peers
Next to other Obstetrics & Gynecology Physician providers in Texas
Rank by total paid#19 of 432
Median peer was paid$103K
This provider vs. median41×
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 | 365 | $7K | |
| 2021 | 21,265 | $827K | |
| 2022 | 32,670 | $1.26M | |
| 2023 | 30,118 | $1.18M | |
| 2024incomplete | 22,685 | $951K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | 19% | 1,410 | 1,394 | $816K |
| 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 | 17% | 15,326 | 11,611 | $699K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 8.8% | 11,340 | 8,921 | $371K |
| 59514 | 7.9% | 530 | 505 | $334K | |
| 76830 | Ultrasound, transvaginal | 6.7% | 3,158 | 2,935 | $285K |
| 59430 | 4.6% | 2,177 | 2,107 | $196K | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 3.7% | 1,571 | 1,548 | $157K |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 3.5% | 5,270 | 5,168 | $146K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 3.5% | 5,277 | 5,171 | $146K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 3.4% | 1,926 | 1,869 | $145K |
| 76818 | 2.7% | 1,330 | 944 | $115K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 2.3% | 1,556 | 1,524 | $95K |
33 more codes
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | 2.0% | 1,009 | $84K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | 1.9% | 1,359 | $81K |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | 1.8% | 1,132 | $78K |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | 1.7% | 3,837 | $74K |
| 99000 | 1.5% | 6,413 | $63K | |
| 76801 | 1.4% | 721 | $61K | |
| 87800 | 1.0% | 1,241 | $44K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 6,256 | $38K |
| 81003 | <1% | 21,264 | $38K | |
| 59020 | <1% | 1,466 | $35K | |
| 76813 | <1% | 342 | $30K | |
| 81025 | <1% | 3,859 | $26K | |
| 87806 | <1% | 653 | $17K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 249 | $13K |
| 99205 | Prolong outpt/office vis | <1% | 83 | $7K |
| 90674 | <1% | 241 | $6K | |
| 82950 | <1% | 1,542 | $6K | |
| 99385 | <1% | 87 | $5K | |
| 81002 | <1% | 2,032 | $5K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 472 | $5K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 283 | $3K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 371 | $3K |
| 90661 | <1% | 65 | $2K | |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | <1% | 12 | $1K |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 14 | $1K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 26 | $864.84 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 28 | $358.62 |
| 87430 | <1% | 14 | $125.67 | |
| 82951 | <1% | 55 | $82.60 | |
| 82952 | <1% | 37 | $16.45 | |
| 0502F | 0% | 980 | $0.00 | |
| 99401 | 0% | 49 | $0.00 | |
| 36415 | Collection of venous blood by venipuncture | 0% | 40 | $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 officialOTERO, FERNANDO (OWNER)