Physician
Orfanos, Gerardo
Orfanos, Gerardo was paid $6.05M by Medicaid between Aug 2019 and Dec 2024, across 74 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 34% of everything it billed.
33Billing provider infoORFANOS, GERARDO
EDINBURG, TX 78539
EDINBURG, TX 78539
33aNPI1306838040assigned 08/18/2005
33bProvider typePediatrics Physician
28Total paid$6.05M
24GClaims240,403
24DCodes billed74
24AFirst – last monthAug 2019 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Texas
Rank by total paid#67 of 1,136
Median peer was paid$329K
This provider vs. median18×
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 | |
|---|---|---|---|
| 2019 | 171 | $6K | |
| 2020 | 7,963 | $214K | |
| 2021 | 45,511 | $1.04M | |
| 2022 | 63,408 | $1.66M | |
| 2023 | 64,839 | $1.67M | |
| 2024incomplete | 58,511 | $1.46M |
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 | 34% | 55,234 | 40,916 | $2.07M |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 19% | 14,670 | 13,512 | $1.16M |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 9.9% | 15,543 | 14,321 | $601K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 5.2% | 4,499 | 4,389 | $314K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 4.6% | 20,807 | 19,073 | $280K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.4% | 3,893 | 3,821 | $268K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 3.7% | 10,355 | 8,152 | $223K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.5% | 3,126 | 2,893 | $213K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 3.0% | 2,598 | 2,531 | $181K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 2.9% | 16,303 | 6,829 | $174K |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | 1.5% | 1,246 | 1,200 | $93K |
| 87634 | 1.4% | 1,446 | 1,288 | $84K |
62 more codes
| 99429 | <1% | 2,011 | $59K | |
| 99382 | <1% | 494 | $44K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 3,263 | $40K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 5,716 | $37K |
| 87807 | <1% | 2,918 | $32K | |
| 99381 | <1% | 389 | $29K | |
| 92558 | <1% | 3,570 | $27K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 336 | $22K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 2,407 | $19K |
| 90461 | <1% | 4,673 | $17K | |
| 99383 | <1% | 200 | $17K | |
| 87801 | Infectious agent detection by nucleic acid; amplified probe, multiple organisms | <1% | 249 | $12K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 250 | $8K |
| 83655 | <1% | 520 | $5K | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 2,142 | $3K |
| 81002 | <1% | 1,035 | $3K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 45 | $3K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 59 | $2K |
| 99384 | <1% | 12 | $1K | |
| 80053 | Comprehensive metabolic panel | <1% | 127 | $1K |
| 86318 | <1% | 73 | $1K | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 7,869 | $1K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 60 | $730.01 |
| 86580 | <1% | 77 | $551.18 | |
| 84030 | <1% | 107 | $495.21 | |
| 96160 | <1% | 456 | $485.89 | |
| 97802 | <1% | 2,311 | $475.47 | |
| J2550 | Injection, promethazine hcl, up to 50 mg | <1% | 162 | $387.51 |
| 80061 | Lipid panel | <1% | 25 | $281.25 |
| 90619 | <1% | 384 | $152.58 | |
| 99051 | <1% | 741 | $127.71 | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 12 | $97.92 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 640 | $75.58 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 55 | $46.79 |
| 85018 | <1% | 321 | $11.94 | |
| 90686 | <1% | 1,407 | $0.36 | |
| 90620 | <1% | 397 | $0.10 | |
| 90715 | <1% | 343 | $0.05 | |
| 90688 | <1% | 103 | $0.05 | |
| 90647 | <1% | 2,175 | $0.03 | |
| 90651 | <1% | 558 | $0.03 | |
| 90716 | <1% | 239 | $0.02 | |
| 90707 | <1% | 243 | $0.01 | |
| 90734 | <1% | 262 | $0.01 | |
| 90710 | 0% | 576 | $0.00 | |
| 90670 | 0% | 1,743 | $0.00 | |
| 90633 | 0% | 1,195 | $0.00 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 2,505 | $0.00 |
| 90700 | 0% | 339 | $0.00 | |
| 90649 | 0% | 140 | $0.00 | |
| 3120F | 0% | 20,567 | $0.00 | |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 5,499 | $0.00 |
| 99174 | 0% | 3,905 | $0.00 | |
| 90680 | 0% | 1,563 | $0.00 | |
| 90677 | 0% | 502 | $0.00 | |
| 90723 | 0% | 1,631 | $0.00 | |
| 90696 | 0% | 370 | $0.00 | |
| 3330F | 0% | 32 | $0.00 | |
| G0010 | Administration of hepatitis b vaccine | 0% | 492 | $0.00 |
| G8418 | Bmi is documented below normal parameters and a follow-up plan is documented | 0% | 105 | $0.00 |
| G0008 | Administration of influenza virus vaccine | 0% | 69 | $0.00 |
| 90697 | 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.