Physician
Jimenez, Marcial
Jimenez, Marcial was paid $269K by Medicaid between Jan 2018 and Aug 2024, across 52 billing codes. Its largest line is 90460, Immunization administration through 18 years of age via any route, first or only component — 17% of everything it billed.
33Billing provider infoJIMENEZ, MARCIAL
BRONX, NY 10458
BRONX, NY 10458
33aNPI1427135268assigned 11/01/2006
33bProvider typePediatrics Physician
28Total paid$269K
24GClaims19,791
24DCodes billed52
24AFirst – last monthJan 2018 – Aug 2024
Compared with peers
Next to other Pediatrics Physician providers in New York
Rank by total paid#535 of 1,983
Median peer was paid$17K
This provider vs. median16×
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 | 3,194 | $55K | |
| 2019 | 3,616 | $64K | |
| 2020 | 3,031 | $43K | |
| 2021 | 8,932 | $93K | |
| 2022 | 575 | $11K | |
| 2023 | 122 | $1K | |
| 2024incomplete | 321 | $3K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 17% | 1,121 | 1,115 | $45K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 15% | 656 | 630 | $41K |
| G0270 | Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes | 12% | 2,478 | 2,464 | $32K |
| 92587 | 9.6% | 986 | 985 | $26K | |
| 99401 | 7.4% | 1,437 | 1,425 | $20K | |
| 99173 | 6.3% | 1,357 | 1,357 | $17K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 6.1% | 413 | 413 | $16K |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 4.6% | 493 | 493 | $12K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 4.4% | 372 | 353 | $12K |
| 99406 | 4.0% | 902 | 701 | $11K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.5% | 398 | 398 | $7K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 1.6% | 429 | 429 | $4K |
40 more codes
| 90472 | Immunization administration, each additional vaccine (list separately) | 1.6% | 147 | $4K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.6% | 285 | $4K |
| 0001A | 1.6% | 97 | $4K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.6% | 164 | $4K |
| 36415 | Collection of venous blood by venipuncture | 1.3% | 1,362 | $4K |
| D1206 | Topical application of fluoride varnish | <1% | 105 | $3K |
| 97802 | <1% | 139 | $2K | |
| 0053A | <1% | 18 | $729.78 | |
| 0051A | <1% | 13 | $549.34 | |
| 91305 | <1% | 41 | $540.27 | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 84 | $269.34 |
| 90686 | <1% | 199 | $19.03 | |
| H0001 | Alcohol and/or drug assessment | <1% | 455 | $2.15 |
| 99408 | <1% | 455 | $2.14 | |
| S9451 | Exercise classes, non-physician provider, per session | 0% | 984 | $0.00 |
| 3008F | 0% | 137 | $0.00 | |
| G9275 | Documentation that patient is a current non-tobacco user | 0% | 368 | $0.00 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 454 | $0.00 |
| 90647 | 0% | 41 | $0.00 | |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 731 | $0.00 |
| 1000F | 0% | 442 | $0.00 | |
| 1036F | 0% | 398 | $0.00 | |
| 90680 | 0% | 38 | $0.00 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 15 | $0.00 |
| 90620 | 0% | 22 | $0.00 | |
| 36406 | 0% | 31 | $0.00 | |
| 90660 | 0% | 53 | $0.00 | |
| 90656 | 0% | 67 | $0.00 | |
| 90723 | 0% | 15 | $0.00 | |
| 90651 | 0% | 12 | $0.00 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 261 | $0.00 |
| 3725F | 0% | 443 | $0.00 | |
| 99080 | 0% | 226 | $0.00 | |
| 90685 | 0% | 146 | $0.00 | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 0% | 74 | $0.00 |
| 90670 | 0% | 64 | $0.00 | |
| 90633 | 0% | 42 | $0.00 | |
| 90672 | 0% | 18 | $0.00 | |
| 91300 | 0% | 71 | $0.00 | |
| 90734 | 0% | 32 | $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.