Physician
South Main Clinic, INC
South Main Clinic, INC was paid $824K by Medicaid between Oct 2019 and Dec 2024, across 59 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 31% of everything it billed.
33Billing provider infoSOUTH MAIN CLINIC, INC
HOUSTON, TX 77035
HOUSTON, TX 77035
33aNPI1326068933assigned 07/20/2006
33bProvider typeGeneral Practice Physician
28Total paid$824K
24GClaims44,416
24DCodes billed59
24AFirst – last monthOct 2019 – Dec 2024
Compared with peers
Next to other General Practice Physician providers in Texas
Rank by total paid#14 of 113
Median peer was paid$22K
This provider vs. median37×
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 | 195 | $5K | |
| 2020 | 4,008 | $82K | |
| 2021 | 10,519 | $200K | |
| 2022 | 12,303 | $206K | |
| 2023 | 9,308 | $172K | |
| 2024incomplete | 8,083 | $160K |
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 | 31% | 6,929 | 5,626 | $258K |
| 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 | 18% | 2,858 | 2,539 | $145K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 13% | 1,176 | 1,111 | $108K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 7.8% | 732 | 713 | $64K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 4.9% | 3,769 | 2,467 | $41K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 4.4% | 901 | 808 | $36K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 4.0% | 3,291 | 1,727 | $33K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 3.9% | 2,393 | 1,089 | $32K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 3.0% | 1,840 | 1,659 | $24K |
| 99000 | 2.4% | 1,985 | 1,763 | $20K | |
| 81002 | 2.0% | 6,000 | 5,162 | $17K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 1.5% | 925 | 788 | $12K |
47 more codes
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 86 | $6K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 71 | $6K |
| 92551 | <1% | 468 | $4K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 57 | $3K |
| 93000 | <1% | 218 | $2K | |
| 90461 | <1% | 263 | $1K | |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | <1% | 13 | $1K |
| 92552 | <1% | 75 | $1K | |
| 94060 | <1% | 38 | $1K | |
| 97169 | <1% | 34 | $1K | |
| J2010 | Injection, lincomycin hcl, up to 300 mg | <1% | 64 | $834.19 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 1,072 | $821.09 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 1,634 | $746.49 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 30 | $723.62 |
| 92567 | <1% | 39 | $451.07 | |
| 94010 | <1% | 25 | $441.33 | |
| 87428 | <1% | 13 | $375.69 | |
| 90686 | <1% | 902 | $310.39 | |
| 97802 | <1% | 1,419 | $302.50 | |
| 81001 | <1% | 118 | $296.43 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 73 | $112.65 |
| 90621 | <1% | 89 | $67.00 | |
| 82570 | <1% | 14 | $36.12 | |
| 82947 | <1% | 16 | $31.85 | |
| J7626 | Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg | <1% | 65 | $27.52 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 472 | $19.29 |
| J0690 | Injection, cefazolin sodium, 500 mg | <1% | 43 | $13.17 |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 1,443 | $1.16 |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 273 | $0.72 |
| 80053 | Comprehensive metabolic panel | <1% | 235 | $0.55 |
| 80061 | Lipid panel | <1% | 215 | $0.51 |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 188 | $0.28 |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 111 | $0.24 |
| 82785 | <1% | 45 | $0.11 | |
| 90734 | <1% | 355 | $0.10 | |
| 80050 | General health panel | <1% | 78 | $0.10 |
| 84439 | <1% | 12 | $0.06 | |
| 90658 | <1% | 32 | $0.01 | |
| 90651 | <1% | 59 | $0.01 | |
| 3725F | 0% | 41 | $0.00 | |
| 90649 | 0% | 188 | $0.00 | |
| 99173 | 0% | 432 | $0.00 | |
| 90715 | 0% | 32 | $0.00 | |
| 86003 | 0% | 43 | $0.00 | |
| 96127 | 0% | 177 | $0.00 | |
| 36415 | Collection of venous blood by venipuncture | 0% | 117 | $0.00 |
| 3008F | 0% | 130 | $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 officialPINILLA, ALVARO (PRESIDENT OWNER)