Physician
Valley Pulmonary Group, PLLC
Valley Pulmonary Group, PLLC was paid $1.72M by Medicaid between Jan 2018 and Dec 2024, across 27 billing codes. Its largest line is 99291, Critical care, evaluation and management of the critically ill patient, first 30-74 minutes — 65% of everything it billed.
33Billing provider infoVALLEY PULMONARY GROUP, PLLC
MCALLEN, TX 78503
MCALLEN, TX 78503
33aNPI1952497398assigned 10/05/2006
33bProvider typePulmonary Disease Physician
28Total paid$1.72M
24GClaims49,242
24DCodes billed27
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pulmonary Disease Physician providers in Texas
Rank by total paid#3 of 92
Median peer was paid$8K
This provider vs. median204×
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 | 13,246 | $230K | |
| 2019 | 12,372 | $313K | |
| 2020 | 7,252 | $341K | |
| 2021 | 6,553 | $387K | |
| 2022 | 4,449 | $232K | |
| 2023 | 3,079 | $157K | |
| 2024incomplete | 2,291 | $63K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 65% | 14,315 | 5,531 | $1.11M |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 9.7% | 10,642 | 4,597 | $166K |
| 99255 | 7.4% | 874 | 855 | $127K | |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 7.2% | 5,419 | 2,666 | $124K |
| 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 | 4.9% | 4,820 | 4,563 | $84K |
| 99223 | Prolong inpt eval add15 m | 3.8% | 2,312 | 2,279 | $65K |
| 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% | 207 | 198 | $11K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 801 | 758 | $8K |
| 99254 | <1% | 65 | 64 | $7K | |
| 94060 | <1% | 323 | 304 | $5K | |
| 94729 | <1% | 203 | 190 | $5K | |
| 94727 | <1% | 169 | 163 | $3K |
15 more codes
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 70 | $3K |
| 94618 | <1% | 37 | $395.77 | |
| 99441 | <1% | 35 | $22.14 | |
| 1123F | 0% | 810 | $0.00 | |
| 1036F | 0% | 2,727 | $0.00 | |
| Q2036 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval) | 0% | 28 | $0.00 |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 120 | $0.00 |
| 90674 | 0% | 19 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 57 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 3,044 | $0.00 |
| G8482 | Influenza immunization administered or previously received | 0% | 843 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 932 | $0.00 |
| 4040F | 0% | 340 | $0.00 | |
| G8851 | Adherence to therapy was assessed at least annually through an objective informatics system or through self-reporting (if objective reporting is not available, documented) | 0% | 12 | $0.00 |
| 1124F | 0% | 18 | $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 officialRODRIGUEZ, RAMON (DIRECTOR)
| Provider | Location | Paid |
|---|---|---|
| Rama Associates LLC | Hagaman, NY | $19.14M |
| Sol Dental PA. | Miami, FL | $50K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.