Physician
Upper Valley Pediatric and Adolescent Healthcare Clinic PA
Upper Valley Pediatric and Adolescent Healthcare Clinic PA was paid $878K by Medicaid between Jan 2020 and Dec 2024, across 36 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 42% of everything it billed.
33Billing provider infoUPPER VALLEY PEDIATRIC AND ADOLESCENT HEALTHCARE CLINIC PA
SAN JUAN, TX 78589
SAN JUAN, TX 78589
33aNPI1528235132assigned 05/13/2008
33bProvider typePediatrics Physician
28Total paid$878K
24GClaims29,426
24DCodes billed36
24AFirst – last monthJan 2020 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Texas
Rank by total paid#397 of 1,136
Median peer was paid$329K
This provider vs. median2.7×
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 | 1,511 | $32K | |
| 2021 | 6,926 | $194K | |
| 2022 | 8,195 | $254K | |
| 2023 | 7,265 | $230K | |
| 2024incomplete | 5,529 | $168K |
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 | 42% | 10,108 | 8,067 | $371K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 12% | 1,279 | 1,272 | $101K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 8.9% | 935 | 931 | $78K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 8.8% | 881 | 871 | $77K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 8.1% | 934 | 926 | $71K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 6.6% | 5,375 | 2,492 | $58K |
| 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 | 3.0% | 516 | 495 | $26K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 2.9% | 622 | 552 | $25K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 2.7% | 1,766 | 840 | $23K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.6% | 1,034 | 976 | $14K |
| 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% | 134 | 132 | $8K |
| 99429 | <1% | 219 | 219 | $7K |
24 more codes
| 90461 | <1% | 1,730 | $7K | |
| 99050 | <1% | 260 | $3K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 288 | $2K |
| 87807 | <1% | 233 | $2K | |
| 92551 | <1% | 415 | $2K | |
| 97169 | <1% | 12 | $450.00 | |
| 99381 | <1% | 13 | $422.55 | |
| 96160 | <1% | 257 | $297.00 | |
| 99051 | <1% | 98 | $44.82 | |
| 90677 | <1% | 147 | $0.12 | |
| 90734 | 0% | 56 | $0.00 | |
| 90715 | 0% | 13 | $0.00 | |
| 99173 | 0% | 412 | $0.00 | |
| 90670 | 0% | 674 | $0.00 | |
| 90633 | 0% | 186 | $0.00 | |
| 90648 | 0% | 261 | $0.00 | |
| 99080 | 0% | 27 | $0.00 | |
| 90621 | 0% | 15 | $0.00 | |
| 90672 | 0% | 26 | $0.00 | |
| 90681 | 0% | 77 | $0.00 | |
| 90651 | 0% | 78 | $0.00 | |
| 90686 | 0% | 229 | $0.00 | |
| 90723 | 0% | 44 | $0.00 | |
| 90656 | 0% | 72 | $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 officialCANTU, ROEL (PHYSICIAN/OWNER)