Physician
Ortega, Cesar
Ortega, Cesar was paid $1.54M by Medicaid between Jan 2018 and Oct 2022, across 56 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 22% of everything it billed.
33Billing provider infoORTEGA, CESAR
HOUSTON, TX 77093
HOUSTON, TX 77093
33aNPI1639159148assigned 01/19/2006
33bProvider typePediatrics Physician
28Total paid$1.54M
24GClaims71,603
24DCodes billed56
24AFirst – last monthJan 2018 – Oct 2022
Compared with peers
Next to other Pediatrics Physician providers in Texas
Rank by total paid#290 of 1,136
Median peer was paid$329K
This provider vs. median4.7×
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 | |
|---|---|---|---|
| 2018 | 604 | $21K | |
| 2019 | 7,259 | $162K | |
| 2020 | 39,890 | $819K | |
| 2021 | 22,497 | $509K | |
| 2022 | 1,353 | $33K |
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 | 22% | 9,911 | 8,814 | $336K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 15% | 2,916 | 2,892 | $235K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 13% | 2,377 | 2,290 | $202K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 13% | 2,605 | 2,537 | $196K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 7.7% | 1,571 | 1,549 | $119K |
| 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 | 7.1% | 2,316 | 2,157 | $109K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 4.6% | 9,636 | 4,190 | $71K |
| 99381 | 3.1% | 594 | 590 | $48K | |
| 99429 | 1.8% | 950 | 923 | $28K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.8% | 1,149 | 1,120 | $27K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.7% | 3,302 | 2,480 | $26K |
| 99000 | 1.6% | 2,689 | 2,316 | $25K |
44 more codes
| 90461 | 1.0% | 2,325 | $16K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 541 | $15K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 379 | $15K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 1,672 | $13K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 892 | $10K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,278 | $9K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 474 | $7K |
| 96160 | <1% | 2,479 | $6K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 71 | $4K |
| 99383 | <1% | 40 | $4K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 41 | $3K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 435 | $3K |
| 99051 | <1% | 328 | $3K | |
| 0001A | <1% | 86 | $3K | |
| 0002A | <1% | 56 | $2K | |
| 94010 | <1% | 60 | $2K | |
| 90474 | <1% | 189 | $1K | |
| 81002 | <1% | 520 | $1K | |
| 97169 | <1% | 29 | $785.00 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 46 | $701.27 |
| A4617 | Mouth piece | <1% | 64 | $213.46 |
| 90620 | <1% | 471 | $67.34 | |
| A7015 | Aerosol mask, used with dme nebulizer | <1% | 45 | $65.64 |
| 90696 | <1% | 285 | $52.50 | |
| 90734 | <1% | 893 | $27.92 | |
| 96161 | <1% | 114 | $11.12 | |
| 90648 | <1% | 1,131 | $5.78 | |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 43 | $1.75 |
| 36416 | <1% | 1,049 | $1.62 | |
| 90670 | 0% | 1,392 | $0.00 | |
| 90633 | 0% | 634 | $0.00 | |
| 90700 | 0% | 136 | $0.00 | |
| 91300 | 0% | 144 | $0.00 | |
| 90707 | 0% | 132 | $0.00 | |
| 90715 | 0% | 422 | $0.00 | |
| 90710 | 0% | 301 | $0.00 | |
| 90723 | 0% | 995 | $0.00 | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 0% | 7,301 | $0.00 |
| 90651 | 0% | 990 | $0.00 | |
| 90686 | 0% | 1,921 | $0.00 | |
| 90680 | 0% | 955 | $0.00 | |
| 90647 | 0% | 59 | $0.00 | |
| 90716 | 0% | 136 | $0.00 | |
| 91307 | 0% | 33 | $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.