Montes, Monica
Montes, Monica was paid $1.10M by Medicaid between Oct 2020 and May 2024, across 2 billing codes. Its largest line is 97530, Therapeutic activities, direct patient contact, each 15 minutes — 100% of everything it billed.
33Billing provider infoMONTES, MONICA
EDINBURG, TX 78539
EDINBURG, TX 78539
33aNPI1477873032assigned 06/07/2010
33bProvider typeOccupational Therapist
28Total paid$1.10M
24GClaims15,495
24DCodes billed2
24AFirst – last monthOct 2020 – May 2024
Compared with peers
Next to other Occupational Therapist providers in Texas
Rank by total paid#32 of 299
Median peer was paid$93K
This provider vs. median12×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Single-Code Concentration100% of spending on code 97530 with only 2 total codes billed. Highly concentrated billing profile.
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 | 871 | $63K | |
| 2021 | 7,206 | $638K | |
| 2022 | 4,190 | $383K | |
| 2023 | 3,139 | $7K | |
| 2024incomplete | 89 | $6K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 100% | 14,320 | 2,114 | $1.09M |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 1,175 | 106 | $2K |
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.