Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

SUMMIT CHILDREN'S CLINIC PA

NPI: 1285752105 · SAN ANTONIO, TX 78212 · Pediatrics Physician · NPI assigned 03/27/2007

$4.47M
Total Medicaid Paid
174,868
Total Claims
142,275
Beneficiaries
55
Codes Billed
2018-05
First Month
2024-12
Last Month

Provider Details

Authorized OfficialRAMON, SERGIO (PHYSICIAN/OWNER)
NPI Enumeration Date03/27/2007

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 195 $4K
2019 41 $1K
2020 8,420 $179K
2021 44,199 $1.04M
2022 44,449 $1.12M
2023 42,585 $1.15M
2024 34,979 $977K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 30,291 27,507 $1.09M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 18,282 16,673 $918K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 6,625 6,327 $535K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 6,284 6,039 $480K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 4,229 4,041 $371K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 4,925 4,525 $360K
90460 Immunization administration through 18 years of age via any route, first or only component 32,354 13,210 $321K
96110 Developmental screening, with scoring and documentation, per standardized instrument 8,965 7,843 $69K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 4,765 4,560 $63K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 2,655 2,479 $62K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 4,721 2,253 $62K
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) 1,167 1,136 $43K
90461 7,318 5,784 $37K
92552 5,400 5,196 $13K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 389 371 $11K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,224 1,143 $10K
96161 3,815 3,644 $6K
99381 64 63 $5K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 43 43 $3K
90480 104 92 $3K
0071A 68 68 $3K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 25 25 $2K
0072A 40 40 $2K
0001A 32 32 $1K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 13 13 $1K
0081A 30 30 $1K
99173 6,840 6,379 $612.00
0002A 14 14 $560.00
90472 Immunization administration, each additional vaccine (list separately) 47 24 $368.48
90619 401 369 $0.13
90621 477 441 $0.02
90688 2,651 2,465 $0.02
90656 751 720 $0.02
90651 1,588 1,481 $0.02
90670 2,908 2,679 $0.01
90633 1,662 1,588 $0.01
90680 2,253 2,110 $0.01
91300 89 87 $0.00
90671 1,189 1,151 $0.00
90707 1,707 1,632 $0.00
90700 191 184 $0.00
90648 134 128 $0.00
90734 621 593 $0.00
90715 407 389 $0.00
90687 1,094 1,031 $0.00
90713 15 14 $0.00
91320 12 12 $0.00
91308 70 67 $0.00
90716 1,866 1,782 $0.00
90697 1,793 1,686 $0.00
90744 699 661 $0.00
90698 1,115 1,030 $0.00
90696 285 275 $0.00
91307 146 132 $0.00
91319 15 14 $0.00