Physician
Southwest Diabetes Center PLLC
Southwest Diabetes Center PLLC was paid $1.11M by Medicaid between Jan 2018 and Mar 2023, across 41 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 63% of everything it billed.
33Billing provider infoSOUTHWEST DIABETES CENTER PLLC
YUMA, AZ 85364
YUMA, AZ 85364
33aNPI1881772317assigned 11/01/2006
33bProvider typeInternal Medicine Physician
28Total paid$1.11M
24GClaims39,646
24DCodes billed41
24AFirst – last monthJan 2018 – Mar 2023
Compared with peers
Next to other Internal Medicine Physician providers in Arizona
Rank by total paid#52 of 395
Median peer was paid$68K
This provider vs. median16×
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 | 11,803 | $178K | |
| 2019 | 7,773 | $229K | |
| 2020 | 4,689 | $203K | |
| 2021 | 6,466 | $231K | |
| 2022 | 7,577 | $224K | |
| 2023 | 1,338 | $49K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 63% | 16,427 | 12,986 | $697K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 21% | 3,734 | 3,049 | $230K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 3.9% | 484 | 465 | $43K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 3.9% | 1,314 | 1,156 | $43K |
| 99490 | Ccm add 20min | 3.6% | 8,967 | 8,555 | $41K |
| 99497 | 1.9% | 1,257 | 1,066 | $22K | |
| 93922 | 1.1% | 308 | 281 | $13K | |
| 95251 | <1% | 209 | 177 | $5K | |
| 0011A | <1% | 163 | 161 | $4K | |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | <1% | 39 | 39 | $4K |
| 0012A | <1% | 102 | 100 | $3K | |
| 0013A | <1% | 92 | 84 | $2K |
29 more codes
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 129 | $2K |
| 90688 | <1% | 240 | $2K | |
| 90756 | <1% | 107 | $1K | |
| 90686 | <1% | 88 | $688.37 | |
| G0008 | Administration of influenza virus vaccine | <1% | 254 | $597.65 |
| 0031A | <1% | 30 | $463.77 | |
| 0134A | <1% | 12 | $419.15 | |
| 99397 | <1% | 40 | $394.64 | |
| 93000 | <1% | 26 | $292.86 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 13 | $209.01 |
| 81002 | <1% | 52 | $72.77 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 288 | $43.88 |
| 91313 | <1% | 26 | $0.02 | |
| 1126F | 0% | 781 | $0.00 | |
| 1157F | 0% | 690 | $0.00 | |
| 91301 | 0% | 324 | $0.00 | |
| 1170F | 0% | 1,081 | $0.00 | |
| 1111F | 0% | 65 | $0.00 | |
| 1125F | 0% | 235 | $0.00 | |
| 3044F | 0% | 166 | $0.00 | |
| 91303 | 0% | 20 | $0.00 | |
| G0506 | Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) | 0% | 16 | $0.00 |
| 0094A | 0% | 14 | $0.00 | |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 102 | $0.00 |
| 1160F | 0% | 1,068 | $0.00 | |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 253 | $0.00 |
| 3045F | 0% | 167 | $0.00 | |
| 1158F | 0% | 243 | $0.00 | |
| 3046F | 0% | 20 | $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 officialPENAHERRERA, SERGIO (OWNER)