Physician
Topcare Medical Group INC
Topcare Medical Group INC was paid $160.36M by Medicaid between Jan 2018 and Dec 2024, across 187 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 20% of everything it billed.
33Billing provider infoTOPCARE MEDICAL GROUP INC
DALLAS, TX 75251
DALLAS, TX 75251
33aNPI1285016758assigned 06/22/2015
33bProvider typePediatrics Physician
28Total paid$160.36M
24GClaims8,433,773
24DCodes billed187
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Texas
Rank by total paid#3 of 1,136
Median peer was paid$329K
This provider vs. median488×
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 | 24,262 | $583K | |
| 2019 | 41,713 | $986K | |
| 2020 | 397,507 | $6.31M | |
| 2021 | 1,591,965 | $32.62M | |
| 2022 | 1,971,256 | $35.40M | |
| 2023 | 2,349,279 | $44.41M | |
| 2024incomplete | 2,057,791 | $40.06M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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% | 848,508 | 783,437 | $31.43M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 14% | 853,615 | 785,171 | $23.00M |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 11% | 535,599 | 509,166 | $17.44M |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 9.6% | 235,403 | 231,955 | $15.35M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 8.6% | 226,622 | 222,350 | $13.79M |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 7.1% | 1,274,860 | 604,459 | $11.33M |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 6.8% | 159,518 | 156,177 | $10.89M |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 6.2% | 161,579 | 151,919 | $9.87M |
| 87400 | 3.0% | 655,520 | 311,911 | $4.84M | |
| 99429 | 2.5% | 162,103 | 158,589 | $3.99M | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 2.4% | 310,815 | 174,073 | $3.77M |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.9% | 318,647 | 303,934 | $3.13M |
175 more codes
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.0% | 258,469 | $1.62M |
| 99381 | <1% | 15,708 | $1.07M | |
| 90461 | <1% | 305,418 | $855K | |
| 99499 | <1% | 8,510 | $853K | |
| 87807 | <1% | 106,915 | $842K | |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | <1% | 17,354 | $835K |
| 99383 | <1% | 9,016 | $723K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 8,614 | $547K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 27,036 | $537K |
| 99382 | <1% | 5,198 | $419K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 9,777 | $368K |
| 99384 | <1% | 3,950 | $351K | |
| 99000 | <1% | 43,229 | $259K | |
| 96160 | <1% | 172,830 | $252K | |
| 0071A | <1% | 6,718 | $223K | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 29,963 | $191K |
| 0072A | <1% | 5,410 | $180K | |
| 83655 | <1% | 24,091 | $174K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 1,457 | $132K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 9,164 | $99K |
| 0001A | <1% | 3,423 | $97K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 1,139 | $75K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 1,405 | $73K |
| 97169 | <1% | 5,949 | $72K | |
| 0002A | <1% | 2,604 | $70K | |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 2,326 | $61K |
| 87428 | <1% | 1,818 | $47K | |
| 87631 | <1% | 343 | $32K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 4,043 | $32K |
| 92567 | <1% | 2,683 | $27K | |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | <1% | 1,171 | $26K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 433 | $26K |
| 81003 | <1% | 19,223 | $24K | |
| 99050 | <1% | 2,202 | $24K | |
| 85018 | <1% | 20,648 | $24K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 654 | $21K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 733 | $20K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 2,509 | $20K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 2,139 | $18K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 277 | $15K |
| 94375 | <1% | 633 | $14K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,677 | $12K |
| 0054A | <1% | 357 | $12K | |
| 90651 | <1% | 92,061 | $12K | |
| 0081A | <1% | 358 | $12K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 365 | $11K |
| 96380 | <1% | 907 | $11K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 1,264 | $11K |
| 90619 | <1% | 13,238 | $9K | |
| 90677 | <1% | 39,783 | $8K | |
| 0052A | <1% | 276 | $7K | |
| 90620 | <1% | 11,915 | $7K | |
| 0051A | <1% | 237 | $6K | |
| 94760 | <1% | 12,079 | $5K | |
| 0082A | <1% | 147 | $5K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 1,294 | $4K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 905 | $4K |
| 0074A | <1% | 122 | $3K | |
| 17250 | <1% | 43 | $3K | |
| 90686 | <1% | 201,359 | $3K | |
| 87070 | <1% | 785 | $3K | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 249 | $2K |
| 85027 | <1% | 481 | $2K | |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 27 | $2K |
| 0003A | <1% | 68 | $2K | |
| 94010 | <1% | 114 | $2K | |
| 83013 | <1% | 87 | $2K | |
| 92551 | <1% | 50,677 | $2K | |
| 90480 | <1% | 135 | $2K | |
| 90670 | <1% | 83,607 | $2K | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | <1% | 192 | $1K |
| 90688 | <1% | 371 | $1K | |
| 97803 | <1% | 503 | $1K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 45 | $1K |
| 88720 | <1% | 340 | $1K | |
| 99460 | <1% | 14 | $1K | |
| 69210 | <1% | 51 | $1K | |
| 90734 | <1% | 27,160 | $891.54 | |
| 99462 | <1% | 22 | $840.46 | |
| 90633 | <1% | 62,512 | $811.45 | |
| 0004A | <1% | 36 | $800.00 | |
| 90621 | <1% | 4,520 | $781.63 | |
| 87634 | <1% | 21 | $640.10 | |
| 0053A | <1% | 35 | $601.20 | |
| 80061 | Lipid panel | <1% | 62 | $461.73 |
| 86308 | <1% | 156 | $454.01 | |
| 0124A | <1% | 13 | $452.00 | |
| 0012A | <1% | 18 | $445.72 | |
| 90474 | <1% | 174 | $403.05 | |
| A7003 | Administration set, with small volume nonfiltered pneumatic nebulizer, disposable | <1% | 2,643 | $366.66 |
| 96161 | <1% | 155 | $266.84 | |
| 99173 | <1% | 63,080 | $251.29 | |
| 90716 | <1% | 30,353 | $223.61 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 560 | $213.70 |
| 83014 | <1% | 87 | $208.95 | |
| 69209 | <1% | 95 | $191.79 | |
| S9441 | Asthma education, non-physician provider, per session | <1% | 140 | $174.28 |
| 81025 | <1% | 27 | $168.33 | |
| 0011A | <1% | 13 | $156.20 | |
| 92552 | <1% | 86 | $133.92 | |
| 93000 | <1% | 15 | $120.70 | |
| 90648 | <1% | 62,427 | $106.79 | |
| 92587 | <1% | 102 | $91.39 | |
| 80053 | Comprehensive metabolic panel | <1% | 31 | $89.07 |
| 86580 | <1% | 12 | $85.50 | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 311,730 | $68.98 |
| 99080 | <1% | 350 | $55.26 | |
| 90696 | <1% | 12,412 | $52.50 | |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 1,703 | $47.27 |
| 85007 | <1% | 24 | $46.58 | |
| 90707 | <1% | 29,658 | $45.10 | |
| 90715 | <1% | 13,013 | $41.51 | |
| J7510 | Prednisolone oral, per 5 mg | <1% | 144 | $40.00 |
| 90473 | <1% | 32 | $28.32 | |
| 90723 | <1% | 39,043 | $26.79 | |
| 90656 | <1% | 33,030 | $26.21 | |
| 3074F | <1% | 875 | $25.00 | |
| 90660 | <1% | 2,348 | $24.68 | |
| 98960 | <1% | 46 | $22.45 | |
| 91307 | <1% | 13,603 | $16.07 | |
| 99051 | <1% | 1,782 | $16.00 | |
| A9150 | Non-prescription drugs | <1% | 646 | $0.40 |
| 90697 | <1% | 32,385 | $0.37 | |
| 90680 | <1% | 27,864 | $0.25 | |
| 92558 | <1% | 26 | $0.17 | |
| 90681 | <1% | 15,905 | $0.04 | |
| 90700 | <1% | 9,046 | $0.04 | |
| 91320 | <1% | 13 | $0.03 | |
| 90756 | <1% | 223 | $0.02 | |
| 99177 | <1% | 475 | $0.01 | |
| 90710 | 0% | 13,610 | $0.00 | |
| 91300 | 0% | 6,939 | $0.00 | |
| 3078F | 0% | 648 | $0.00 | |
| 90649 | 0% | 699 | $0.00 | |
| G9920 | Screening performed and negative | 0% | 30 | $0.00 |
| 90713 | 0% | 311 | $0.00 | |
| G8483 | Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) | 0% | 3,630 | $0.00 |
| S0119 | Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) | 0% | 47 | $0.00 |
| 91308 | 0% | 747 | $0.00 | |
| 4274F | 0% | 1,184 | $0.00 | |
| 99401 | 0% | 80 | $0.00 | |
| G8482 | Influenza immunization administered or previously received | 0% | 5,152 | $0.00 |
| 99001 | 0% | 22 | $0.00 | |
| 90380 | 0% | 138 | $0.00 | |
| 99490 | Ccm add 20min | 0% | 86 | $0.00 |
| G9919 | Screening performed and positive and provision of recommendations | 0% | 12 | $0.00 |
| 3725F | 0% | 14 | $0.00 | |
| 99188 | 0% | 14 | $0.00 | |
| 94664 | 0% | 29 | $0.00 | |
| 91312 | 0% | 15 | $0.00 | |
| 3008F | 0% | 178,074 | $0.00 | |
| 36416 | 0% | 8,322 | $0.00 | |
| 97802 | 0% | 861 | $0.00 | |
| 91305 | 0% | 1,712 | $0.00 | |
| 90698 | 0% | 3,250 | $0.00 | |
| 1030F | 0% | 456 | $0.00 | |
| 96127 | 0% | 168 | $0.00 | |
| 99172 | 0% | 200 | $0.00 | |
| 4037F | 0% | 355 | $0.00 | |
| 90744 | 0% | 667 | $0.00 | |
| 99441 | 0% | 323 | $0.00 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 0% | 15 | $0.00 |
| 90381 | 0% | 237 | $0.00 | |
| 90647 | 0% | 187 | $0.00 | |
| A7004 | Small volume nonfiltered pneumatic nebulizer, disposable | 0% | 14 | $0.00 |
| D9630 | 0% | 25 | $0.00 | |
| 2016F | 0% | 149 | $0.00 | |
| 1005F | 0% | 151 | $0.00 | |
| 36415 | Collection of venous blood by venipuncture | 0% | 16 | $0.00 |
| 91301 | 0% | 33 | $0.00 | |
| H0033 | Oral medication administration, direct observation | 0% | 35 | $0.00 |
| 82962 | 0% | 40 | $0.00 | |
| 87430 | 0% | 14 | $0.00 | |
| 91319 | 0% | 13 | $0.00 | |
| 90674 | 0% | 14 | $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 officialSAENZ, ALVARO (CEO)
Parent organizationTOPCARE MEDICAL GROUP INC
| Provider | Location | Paid |
|---|---|---|
| Topcare Medical Group INC | Dallas, TX | $42.63M |
| Topcare Medical PA | Irving, TX | $561.39 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.