NP / PA
South Loop 12 Medical Clinic LLC
South Loop 12 Medical Clinic LLC was paid $1.70M by Medicaid between Sep 2018 and Dec 2024, across 41 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 18% of everything it billed.
33Billing provider infoSOUTH LOOP 12 MEDICAL CLINIC LLC
DALLAS, TX 75216
DALLAS, TX 75216
33aNPI1417034745assigned 11/01/2006
33bProvider typeFamily Nurse Practitioner
28Total paid$1.70M
24GClaims64,788
24DCodes billed41
24AFirst – last monthSep 2018 – Dec 2024
Compared with peers
Next to other Family Nurse Practitioner providers in Texas
Rank by total paid#10 of 344
Median peer was paid$14K
This provider vs. median123×
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 | 12 | $373.34 | |
| 2019 | 49 | $847.99 | |
| 2020 | 3,830 | $90K | |
| 2021 | 17,613 | $421K | |
| 2022 | 16,277 | $437K | |
| 2023 | 16,328 | $421K | |
| 2024incomplete | 10,679 | $329K |
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 | 18% | 9,129 | 8,819 | $310K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 17% | 3,335 | 3,308 | $291K |
| 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 | 17% | 6,013 | 5,916 | $286K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 17% | 3,602 | 3,576 | $285K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 10% | 2,353 | 2,337 | $177K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 7.9% | 15,424 | 4,782 | $134K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 3.6% | 846 | 829 | $61K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 3.1% | 857 | 833 | $53K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.0% | 320 | 317 | $17K |
| 99000 | <1% | 1,808 | 1,745 | $17K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 1,934 | 1,913 | $15K |
| 90461 | <1% | 3,811 | 2,906 | $10K |
29 more codes
| 99383 | <1% | 108 | $9K | |
| 99382 | <1% | 81 | $7K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 315 | $7K |
| 99381 | <1% | 82 | $7K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 69 | $6K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 503 | $4K |
| 99384 | <1% | 40 | $4K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 140 | $1K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 12 | $875.49 |
| 81025 | <1% | 111 | $432.65 | |
| 90734 | <1% | 1,055 | $0.85 | |
| 90620 | <1% | 363 | $0.80 | |
| 90677 | <1% | 304 | $0.78 | |
| 90632 | <1% | 161 | $0.74 | |
| 90733 | <1% | 177 | $0.49 | |
| 90651 | <1% | 1,004 | $0.35 | |
| 90715 | <1% | 511 | $0.27 | |
| 90658 | <1% | 357 | $0.24 | |
| 90649 | <1% | 249 | $0.06 | |
| 90633 | <1% | 659 | $0.03 | |
| 90713 | <1% | 1,599 | $0.02 | |
| 90707 | <1% | 951 | $0.02 | |
| 90716 | <1% | 938 | $0.01 | |
| 90700 | 0% | 1,983 | $0.00 | |
| 90648 | 0% | 1,445 | $0.00 | |
| 90670 | 0% | 1,103 | $0.00 | |
| 90714 | 0% | 54 | $0.00 | |
| 90680 | 0% | 361 | $0.00 | |
| 90744 | 0% | 621 | $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 officialNELLUM, CONNIE (FAMILY NURSE PACTITIONE CERTIFIED)