Physician
Jimenez Pediatrics
Jimenez Pediatrics was paid $7.51M by Medicaid between Jan 2018 and Dec 2024, across 72 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 39% of everything it billed.
33Billing provider infoJIMENEZ PEDIATRICS
EDINBURG, TX 78539
EDINBURG, TX 78539
33aNPI1457656647assigned 01/19/2011
33bProvider typePediatrics Physician
28Total paid$7.51M
24GClaims283,712
24DCodes billed72
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Texas
Rank by total paid#45 of 1,136
Median peer was paid$329K
This provider vs. median23×
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 | 319 | $12K | |
| 2019 | 366 | $13K | |
| 2020 | 9,746 | $206K | |
| 2021 | 69,203 | $1.70M | |
| 2022 | 81,345 | $2.19M | |
| 2023 | 68,008 | $1.83M | |
| 2024incomplete | 54,725 | $1.56M |
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 | 39% | 81,103 | 60,407 | $2.90M |
| 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 | 21% | 32,392 | 27,344 | $1.61M |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 6.5% | 6,254 | 6,168 | $487K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 5.6% | 5,544 | 5,441 | $421K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 5.4% | 5,088 | 4,998 | $404K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 3.2% | 22,285 | 10,381 | $237K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 3.1% | 3,247 | 3,075 | $233K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 3.1% | 5,917 | 5,430 | $229K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 2.6% | 14,685 | 6,971 | $193K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.7% | 9,598 | 9,132 | $130K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.0% | 1,842 | 1,685 | $76K |
| 92557 | <1% | 2,424 | 2,412 | $73K |
60 more codes
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 9,124 | $59K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 745 | $55K |
| 99429 | <1% | 2,124 | $55K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 6,644 | $53K |
| 92552 | <1% | 4,765 | $42K | |
| 90461 | <1% | 19,027 | $41K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 674 | $39K |
| 17110 | <1% | 374 | $33K | |
| 99381 | <1% | 266 | $18K | |
| 92551 | <1% | 4,128 | $17K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,435 | $17K |
| 87807 | <1% | 1,244 | $13K | |
| 0071A | <1% | 242 | $9K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 91 | $8K |
| 99051 | <1% | 3,417 | $7K | |
| 0072A | <1% | 169 | $7K | |
| 96160 | <1% | 5,465 | $6K | |
| 81003 | <1% | 3,287 | $6K | |
| 80061 | Lipid panel | <1% | 628 | $6K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 761 | $5K |
| 81025 | <1% | 640 | $5K | |
| 97169 | <1% | 165 | $4K | |
| 86318 | <1% | 303 | $4K | |
| 82947 | <1% | 819 | $3K | |
| 96161 | <1% | 4,551 | $1K | |
| 99384 | <1% | 12 | $1K | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 56 | $663.78 |
| J0690 | Injection, cefazolin sodium, 500 mg | <1% | 575 | $414.84 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 633 | $346.62 |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 27 | $284.57 |
| 86580 | <1% | 20 | $129.20 | |
| 81002 | <1% | 24 | $49.64 | |
| 90686 | <1% | 2,764 | $1.79 | |
| 90651 | <1% | 527 | $0.26 | |
| 90671 | <1% | 221 | $0.15 | |
| 90734 | <1% | 1,423 | $0.11 | |
| 90715 | <1% | 893 | $0.09 | |
| 90621 | <1% | 41 | $0.08 | |
| 90620 | <1% | 14 | $0.04 | |
| 90658 | <1% | 12 | $0.01 | |
| 90710 | <1% | 1,649 | $0.01 | |
| 90633 | <1% | 1,709 | $0.01 | |
| 90656 | <1% | 188 | $0.01 | |
| 90700 | 0% | 579 | $0.00 | |
| 90648 | 0% | 2,493 | $0.00 | |
| 90681 | 0% | 628 | $0.00 | |
| 90707 | 0% | 13 | $0.00 | |
| 90670 | 0% | 2,776 | $0.00 | |
| 90649 | 0% | 518 | $0.00 | |
| 83655 | 0% | 17 | $0.00 | |
| 90744 | 0% | 12 | $0.00 | |
| 90696 | 0% | 727 | $0.00 | |
| 90723 | 0% | 1,744 | $0.00 | |
| 96127 | 0% | 284 | $0.00 | |
| 90680 | 0% | 797 | $0.00 | |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | 0% | 27 | $0.00 |
| 90698 | 0% | 326 | $0.00 | |
| 91307 | 0% | 476 | $0.00 | |
| 85027 | 0% | 26 | $0.00 | |
| 90716 | 0% | 14 | $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 officialJIMENEZ, DAVID (PRESIDENT)