Physician
Antonio Esparza, M.D., P.A.
Antonio Esparza, M.D., P.A. was paid $10.99M by Medicaid between Jan 2018 and Dec 2024, across 80 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 21% of everything it billed.
33Billing provider infoANTONIO ESPARZA, M.D., P.A.
PHARR, TX 78577
PHARR, TX 78577
33aNPI1952526626assigned 04/16/2007
33bProvider typePediatrics Physician
28Total paid$10.99M
24GClaims413,800
24DCodes billed80
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Texas
Rank by total paid#20 of 1,136
Median peer was paid$329K
This provider vs. median33×
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 | 1,462 | $41K | |
| 2019 | 1,261 | $38K | |
| 2020 | 17,532 | $318K | |
| 2021 | 90,333 | $2.07M | |
| 2022 | 112,261 | $3.24M | |
| 2023 | 105,461 | $3.10M | |
| 2024incomplete | 85,490 | $2.19M |
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 | 21% | 60,648 | 44,278 | $2.29M |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 18% | 46,540 | 37,435 | $1.97M |
| 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 | 15% | 31,410 | 26,005 | $1.65M |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 12% | 17,672 | 15,355 | $1.33M |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 5.3% | 7,127 | 6,946 | $583K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 4.6% | 5,657 | 5,500 | $505K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 4.1% | 5,803 | 5,629 | $448K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 3.5% | 29,585 | 25,281 | $388K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 3.1% | 26,227 | 11,409 | $346K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2.2% | 3,293 | 3,192 | $247K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 2.2% | 23,709 | 10,214 | $246K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.4% | 24,327 | 20,946 | $154K |
68 more codes
| 99429 | <1% | 2,334 | $77K | |
| 99051 | <1% | 17,740 | $76K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 812 | $73K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 889 | $54K |
| 99000 | <1% | 4,074 | $41K | |
| 0001A | <1% | 864 | $33K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 405 | $33K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,322 | $33K |
| 0002A | <1% | 830 | $33K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 607 | $30K |
| 0071A | <1% | 727 | $29K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 2,444 | $27K |
| 90461 | <1% | 4,284 | $26K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 3,171 | $25K |
| 99381 | <1% | 319 | $25K | |
| 0072A | <1% | 608 | $24K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,919 | $20K |
| 92551 | <1% | 3,181 | $19K | |
| 92567 | <1% | 1,424 | $18K | |
| 87428 | <1% | 606 | $16K | |
| 92587 | <1% | 905 | $16K | |
| 83655 | <1% | 1,491 | $15K | |
| 0003A | <1% | 369 | $14K | |
| G9716 | Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason | <1% | 14,022 | $12K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 871 | $10K |
| 96160 | <1% | 4,533 | $9K | |
| 81003 | <1% | 3,838 | $7K | |
| 87634 | <1% | 93 | $5K | |
| 99050 | <1% | 329 | $5K | |
| 0073A | <1% | 115 | $5K | |
| S8301 | Infection control supplies, not otherwise specified | <1% | 329 | $4K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 342 | $3K |
| 97170 | <1% | 73 | $3K | |
| 97169 | <1% | 84 | $2K | |
| 0081A | <1% | 42 | $2K | |
| 99384 | <1% | 16 | $1K | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 670 | $1K |
| 87807 | <1% | 79 | $850.32 | |
| 0154A | <1% | 15 | $600.00 | |
| 85027 | <1% | 100 | $472.41 | |
| 86580 | <1% | 39 | $42.12 | |
| 90686 | <1% | 2,207 | $20.19 | |
| 90671 | <1% | 841 | $0.82 | |
| 90651 | <1% | 2,029 | $0.80 | |
| 90620 | <1% | 1,447 | $0.54 | |
| 90677 | <1% | 432 | $0.34 | |
| 90688 | <1% | 699 | $0.01 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 20,821 | $0.00 |
| 90696 | 0% | 780 | $0.00 | |
| 90680 | 0% | 2,064 | $0.00 | |
| 90716 | 0% | 407 | $0.00 | |
| 4037F | 0% | 2,616 | $0.00 | |
| 36415 | Collection of venous blood by venipuncture | 0% | 403 | $0.00 |
| 90723 | 0% | 2,238 | $0.00 | |
| 90656 | 0% | 262 | $0.00 | |
| 91307 | 0% | 66 | $0.00 | |
| D1208 | Topical application of fluoride, excluding varnish | 0% | 143 | $0.00 |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 0% | 704 | $0.00 |
| 90710 | 0% | 1,069 | $0.00 | |
| 90700 | 0% | 613 | $0.00 | |
| 90648 | 0% | 2,984 | $0.00 | |
| 90715 | 0% | 1,065 | $0.00 | |
| 90633 | 0% | 1,617 | $0.00 | |
| 90734 | 0% | 1,894 | $0.00 | |
| 90670 | 0% | 1,691 | $0.00 | |
| 90707 | 0% | 370 | $0.00 | |
| 99173 | 0% | 3,921 | $0.00 | |
| 91300 | 0% | 1,504 | $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 officialESPARZA, ANTONIO (PRESIDENT)