Physician
Nelson Spinetti MD PA
Nelson Spinetti MD PA was paid $3.61M by Medicaid between Sep 2020 and Dec 2024, across 46 billing codes. Its largest line is 93975, — 20% of everything it billed.
33Billing provider infoNELSON SPINETTI MD PA
EDINBURG, TX 78539
EDINBURG, TX 78539
33aNPI1457525917assigned 04/16/2008
33bProvider typePediatric Gastroenterology Physician
28Total paid$3.61M
24GClaims43,023
24DCodes billed46
24AFirst – last monthSep 2020 – Dec 2024
Compared with peers
Next to other Pediatric Gastroenterology Physician providers in Texas
Rank by total paid#1 of 13
Median peer was paid$260K
This provider vs. median14×
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 | 535 | $39K | |
| 2021 | 7,150 | $521K | |
| 2022 | 8,034 | $904K | |
| 2023 | 8,126 | $961K | |
| 2024incomplete | 19,178 | $1.19M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 93975 | 20% | 3,418 | 3,348 | $726K | |
| 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 | 14% | 9,973 | 9,029 | $504K |
| 88313 | 11% | 1,529 | 1,133 | $406K | |
| 99245 | 9.1% | 2,027 | 1,961 | $327K | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 8.6% | 1,426 | 1,138 | $312K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | 8.3% | 2,445 | 2,387 | $301K |
| 88312 | 7.4% | 1,335 | 1,135 | $267K | |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 5.8% | 2,104 | 2,051 | $210K |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | 5.2% | 3,546 | 3,455 | $189K |
| 74240 | 5.2% | 1,850 | 1,822 | $187K | |
| 86003 | <1% | 256 | 218 | $22K | |
| 74019 | <1% | 746 | 731 | $21K |
34 more codes
| 82024 | <1% | 568 | $17K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 199 | $15K |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 364 | $13K |
| 82785 | <1% | 640 | $8K | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 589 | $7K |
| 82533 | <1% | 568 | $7K | |
| 99000 | <1% | 718 | $6K | |
| 70220 | <1% | 186 | $6K | |
| 17250 | <1% | 86 | $5K | |
| 82728 | <1% | 559 | $5K | |
| 80061 | Lipid panel | <1% | 509 | $5K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 697 | $4K |
| 91038 | <1% | 13 | $4K | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 622 | $4K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 563 | $4K |
| 80076 | <1% | 665 | $4K | |
| 84681 | <1% | 239 | $4K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 127 | $3K |
| 82150 | <1% | 645 | $3K | |
| 84436 | <1% | 587 | $3K | |
| 84480 | <1% | 237 | $3K | |
| 83525 | <1% | 237 | $2K | |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 12 | $2K |
| 83735 | <1% | 366 | $2K | |
| 82977 | <1% | 362 | $2K | |
| 82550 | <1% | 355 | $2K | |
| 83615 | <1% | 349 | $2K | |
| 91065 | <1% | 15 | $990.22 | |
| 84100 | <1% | 201 | $744.52 | |
| 82274 | <1% | 29 | $347.62 | |
| 99152 | <1% | 21 | $80.80 | |
| 99153 | Mod sedat endo service >5yrs | <1% | 21 | $34.80 |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | 0% | 616 | $0.00 |
| 36415 | Collection of venous blood by venipuncture | 0% | 403 | $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 officialSPINETTI, NELSON (OWNER)