Physician
Martinez, Heriberto
Martinez, Heriberto was paid $318K by Medicaid between Jan 2018 and Nov 2024, across 12 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 36% of everything it billed.
33Billing provider infoMARTINEZ, HERIBERTO
CICERO, IL 60804
CICERO, IL 60804
33aNPI1336115294assigned 02/28/2006
33bProvider typePediatrics Physician
28Total paid$318K
24GClaims12,156
24DCodes billed12
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Pediatrics Physician providers in Illinois
Rank by total paid#407 of 1,805
Median peer was paid$55K
This provider vs. median5.8×
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 | 553 | $19K | |
| 2019 | 2,829 | $78K | |
| 2020 | 2,508 | $66K | |
| 2021 | 2,676 | $59K | |
| 2022 | 1,819 | $48K | |
| 2023 | 1,070 | $29K | |
| 2024incomplete | 701 | $20K |
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 | 36% | 1,811 | 1,596 | $116K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 36% | 2,536 | 2,205 | $115K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 12% | 501 | 435 | $39K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 10% | 456 | 401 | $33K |
| 36415 | Collection of venous blood by venipuncture | 1.8% | 1,343 | 1,246 | $6K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.4% | 56 | 56 | $4K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.2% | 246 | 234 | $4K |
| 99051 | <1% | 400 | 344 | $825.00 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 27 | 26 | $334.49 |
| 99173 | <1% | 39 | 38 | $290.55 | |
| 1003F | 0% | 919 | 793 | $0.00 | |
| 3008F | 0% | 3,822 | 3,147 | $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.