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    OpenPayerNPI Medicare & MedicaidRio Grande Valley Adult & Internal Medicine Specia…
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    Rio Grande Valley Adult & Internal Medicine Specialists PLLC — Billing Profile & Reimbursement Data

    NPI 1528039120 · Weslaco, TX · Internal Medicine Physician

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    Rio Grande Valley Adult & Internal Medicine Specialists PLLC is a internal medicine physician provider located in Weslaco, Texas. This profile covers 0 Medicare and 170 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationRio Grande Valley Adult & Internal Medicine Specialists PLLC
    Address1010 James St
    CityWeslaco
    StateTX
    ZIP78596
    TaxonomyInternal Medicine Physician
    NPI EnumeratedJanuary 31, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$15.8M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    170 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…106,000$30$3.6M
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…67,700$40$2.8M
    U00022019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc40,590$50$1.9M
    87880The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.67,860$10$882.2K
    87804The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.65,110$10$846.4K
    99000Use this code for the in office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory.71,460$10$714.6K
    99392Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…8,480$80$652.7K
    99393The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.7,350$80$588K
    90460In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.47,050$10$517.5K
    99394The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.6,090$80$511.5K

    Showing 1–10 of 170

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    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Texas providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Texas median

    170 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    U00042019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…58100470$50$319.1K
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…426,040710$40$232.8K
    99392Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…721,500880$80$185.8K
    99391Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…971,360800$80$185.6K
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…315,810540$50$155.5K
    99393The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.541,540650$80$150.4K
    93005The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…2813101,210$50$140.4K
    99444N/A712101,220$50$121.2K
    99394The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.491,540360$80$110.6K
    90460In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.451,6502,350$10$88.7K

    Showing 1–10 of 170

    • More pages

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Rio Grande Valley Adult & Internal Medicine Specialists PLLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Pedro McdougalTXGeriatric Medicine (Internal Medicine) Physician$628.6K$0

    Nearby Providers

    Other providers in the same ZIP code as Rio Grande Valley Adult & Internal Medicine Specialists PLLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Pas Home Care, LLCTXHome Health Agency$0$55M
    Adl Services, Inc.TXPersonal Care Attendant$0$23.9M
    Odp Management LLCTXPersonal Care Attendant$0$17.2M
    Idea Public Schools, Inc.TXLocal Education Agency (LEA)$0$16M
    Life Home Health Care, Inc.TXHome Health Agency$0$15.1M
    P.a.c.e. Health Care, Inc.TXHome Health Agency$0$14.6M
    Rodeo Weslaco Dental & OrthodonticsTXDentist$0$14M
    Santa Fe Phc, LLCTXPersonal Care Attendant$0$12.2M
    Promesa Home Health, Inc.TXHome Health Agency$0$11.9M
    Vhs Harlingen Hospital Company, LLCTXGeneral Acute Care Hospital$0$11.8M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Texas Providers
    4 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Texas Distribution
    Rio Grande Valley Adult & Internal Medicine Specialists PLLC — 15 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Texas