S-S-C

S-S-C was paid $428K by Medicaid between Jan 2018 and Nov 2024, across 40 billing codes. Its largest line is 99309, Subsequent nursing facility care, per day, low to moderate complexity — 45% of everything it billed.

33Billing provider infoS-S-C
ALICE, TX 78332

33aNPI1972874287assigned 01/18/2012

33bProvider typeFamily Medicine Physician

28Total paid$428K

24GClaims81,832

24DCodes billed40

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Family Medicine Physician providers in Texas

Rank by total paid#198 of 1,204

Median peer was paid$31K

This provider vs. median14×

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	15,192	$45K
2019	12,495	$36K
2020	16,820	$48K
2021	16,004	$112K
2022	12,298	$94K
2023	1,510	$35K
2024incomplete	7,513	$58K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99309	Subsequent nursing facility care, per day, low to moderate complexity	45%	35,066	9,635	$194K
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%	5,373	4,521	$97K
99308	Subsequent nursing facility care, per day, straightforward	10%	9,853	4,818	$43K
99349		4.6%	457	442	$20K
99497		3.6%	6,046	5,919	$15K
G0181	Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allowed practitioner development and/or revision of care plans	3.5%	5,778	5,778	$15K
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	2.5%	1,137	1,034	$11K
S8301	Infection control supplies, not otherwise specified	1.7%	253	217	$7K
99407		1.5%	1,565	1,539	$6K
99336		1.2%	1,363	1,340	$5K
G0179	Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care	<1%	2,597	2,597	$3K
99337		<1%	45	45	$3K

28 more codes

99306	Prolong nursin fac eval 15m	<1%	120	$2K
99490	Ccm add 20min	<1%	6,916	$2K
99213	Doctor's office visit, returning patient (routine)	<1%	165	$1K
G2012	Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion	<1%	715	$745.89
99316		<1%	56	$730.14
93000		<1%	43	$307.87
90688		<1%	160	$108.36
99318		<1%	180	$107.98
G0180	Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care	<1%	47	$52.08
J1885	Injection, ketorolac tromethamine, per 15 mg	<1%	615	$40.30
90661		<1%	17	$26.10
J1100	Injection, dexamethasone sodium phosphate, 1 mg	<1%	722	$15.84
J0696	Injection, ceftriaxone sodium, per 250 mg	<1%	17	$6.47
G0444	Annual depression screening, 5 to 15 minutes	0%	261	$0.00
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	0%	224	$0.00
G0446	Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes	0%	261	$0.00
90756		0%	13	$0.00
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established)	0%	73	$0.00
99072		0%	31	$0.00
G8752	Most recent systolic blood pressure < 140 mmhg	0%	18	$0.00
1123F		0%	385	$0.00
G0442	Annual alcohol misuse screening, 5 to 15 minutes	0%	261	$0.00
G0182	Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other studies, communication (including telephone calls) with other health care professionals involved in the patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month, 30 minutes or more	0%	356	$0.00
G8754	Most recent diastolic blood pressure < 90 mmhg	0%	18	$0.00
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	0%	367	$0.00
G0008	Administration of influenza virus vaccine	0%	183	$0.00
99496		0%	62	$0.00
1111F		0%	13	$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 officialCANTU, SERGIO (PRESIDENT)

Parent organizationS-S-C