Physician
Flores, Efrain
Flores, Efrain was paid $1.43M by Medicaid between Jan 2018 and Dec 2024, across 44 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 40% of everything it billed.
33Billing provider infoFLORES, EFRAIN
BOLINGBROOK, IL 60440
BOLINGBROOK, IL 60440
33aNPI1922106640assigned 09/20/2006
33bProvider typePediatrics Physician
28Total paid$1.43M
24GClaims33,299
24DCodes billed44
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Illinois
Rank by total paid#79 of 1,805
Median peer was paid$55K
This provider vs. median26×
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 | 6,772 | $245K | |
| 2019 | 5,832 | $235K | |
| 2020 | 5,045 | $200K | |
| 2021 | 3,534 | $171K | |
| 2022 | 4,745 | $209K | |
| 2023 | 4,043 | $182K | |
| 2024incomplete | 3,328 | $188K |
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 | 40% | 11,424 | 9,130 | $566K |
| 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 | 23% | 4,359 | 3,603 | $325K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 9.1% | 1,717 | 1,564 | $130K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 8.8% | 1,505 | 1,412 | $125K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 5.1% | 959 | 810 | $73K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 2.1% | 2,464 | 1,660 | $30K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.8% | 904 | 773 | $25K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 1.6% | 1,827 | 1,569 | $23K |
| 90651 | 1.4% | 653 | 560 | $19K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.3% | 283 | 235 | $19K |
| 90686 | 1.0% | 1,238 | 1,131 | $15K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 291 | 214 | $9K |
32 more codes
| 90734 | <1% | 559 | $9K | |
| 90670 | <1% | 455 | $6K | |
| 90620 | <1% | 292 | $6K | |
| 83655 | <1% | 413 | $5K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 1,160 | $5K |
| 87428 | <1% | 71 | $4K | |
| 0072A | <1% | 102 | $4K | |
| 0071A | <1% | 98 | $4K | |
| 0001A | <1% | 82 | $3K | |
| 90715 | <1% | 206 | $3K | |
| 0002A | <1% | 56 | $2K | |
| 90716 | <1% | 126 | $2K | |
| 90707 | <1% | 176 | $2K | |
| 96127 | <1% | 128 | $2K | |
| 90633 | <1% | 152 | $2K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 62 | $2K |
| 90688 | <1% | 202 | $1K | |
| 85018 | <1% | 600 | $1K | |
| 90677 | <1% | 18 | $1K | |
| 90648 | <1% | 147 | $1K | |
| 0003A | <1% | 20 | $842.80 | |
| 90698 | <1% | 64 | $771.81 | |
| 86580 | <1% | 164 | $688.94 | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 14 | $668.78 |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 16 | $640.00 |
| 90700 | <1% | 70 | $528.80 | |
| 90696 | <1% | 28 | $377.95 | |
| 90710 | <1% | 14 | $233.94 | |
| 90744 | <1% | 17 | $108.80 | |
| 91307 | <1% | 98 | $25.14 | |
| 91300 | <1% | 45 | $12.72 | |
| 90668 | 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.