Physician
Luis Valencia MD PA
Luis Valencia MD PA was paid $1.33M by Medicaid between Jun 2020 and Feb 2024, across 42 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 70% of everything it billed.
33Billing provider infoLUIS VALENCIA MD PA
RIO GRANDE CITY, TX 78582
RIO GRANDE CITY, TX 78582
33aNPI1316370430assigned 08/13/2013
33bProvider typePediatrics Physician
28Total paid$1.33M
24GClaims47,034
24DCodes billed42
24AFirst – last monthJun 2020 – Feb 2024
Compared with peers
Next to other Pediatrics Physician providers in Texas
Rank by total paid#322 of 1,136
Median peer was paid$329K
This provider vs. median4.0×
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 | 1,649 | $30K | |
| 2021 | 9,735 | $280K | |
| 2022 | 17,822 | $527K | |
| 2023 | 16,867 | $460K | |
| 2024incomplete | 961 | $30K |
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 | 70% | 25,851 | 17,356 | $923K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 6.3% | 1,103 | 1,087 | $84K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 5.3% | 1,341 | 1,288 | $71K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 5.2% | 886 | 859 | $69K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.4% | 821 | 783 | $58K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.8% | 650 | 616 | $51K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 2.1% | 2,877 | 2,727 | $28K |
| 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 | <1% | 219 | 205 | $11K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 987 | 825 | $7K |
| 90461 | <1% | 3,629 | 1,665 | $6K | |
| 0071A | <1% | 88 | 85 | $3K | |
| 0072A | <1% | 66 | 66 | $3K |
30 more codes
| T1015 | A visit at a community health center or clinic (one all-in rate) | <1% | 440 | $2K |
| 92558 | <1% | 280 | $2K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 191 | $2K |
| 92587 | <1% | 197 | $1K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 12 | $1K |
| 99381 | <1% | 13 | $929.61 | |
| 99384 | <1% | 17 | $892.36 | |
| 90473 | <1% | 275 | $752.64 | |
| 96160 | <1% | 535 | $723.97 | |
| 99051 | <1% | 580 | $567.72 | |
| 96161 | <1% | 1,391 | $469.69 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 18 | $133.28 |
| 90686 | <1% | 727 | $18.24 | |
| 90734 | <1% | 161 | $0.03 | |
| 90670 | 0% | 1,010 | $0.00 | |
| 90649 | 0% | 141 | $0.00 | |
| 90633 | 0% | 364 | $0.00 | |
| 90710 | 0% | 183 | $0.00 | |
| 90700 | 0% | 135 | $0.00 | |
| 90648 | 0% | 40 | $0.00 | |
| 90715 | 0% | 13 | $0.00 | |
| 90707 | 0% | 15 | $0.00 | |
| 90680 | 0% | 620 | $0.00 | |
| 90744 | 0% | 247 | $0.00 | |
| 90698 | 0% | 626 | $0.00 | |
| 90647 | 0% | 136 | $0.00 | |
| 90696 | 0% | 16 | $0.00 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 0% | 99 | $0.00 |
| 90723 | 0% | 17 | $0.00 | |
| 90716 | 0% | 17 | $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 officialVALENCIA, LUIS (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Luis Valencia MD PA | Rio Grande City, TX | $1.38M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.