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    OpenPayerNPI Medicare & MedicaidSergio Cantu
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    Sergio Cantu — Billing Profile & Reimbursement Data

    NPI 1770862047 · Alice, TX · Family Medicine Physician

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    Sergio Cantu is a family medicine physician provider located in Alice, Texas. This profile covers 33 Medicare and 0 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 TypeIndividual
    OrganizationSergio Cantu
    Address779 N Texas Blvd
    CityAlice
    StateTX
    ZIP78332
    TaxonomyFamily Medicine Physician
    NPI EnumeratedAugust 4, 2011

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

    Payer SourceTotal Paid
    Medicare$1.1M
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    33 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99309The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…6,560$80$524.9K
    99308The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…1,570$50$81.4K
    99497The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…1,390$60$80.3K
    G0181Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and…1,000$80$77.7K
    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…880$80$73.9K
    99490The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…1,450$40$59.6K
    99349The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…470$90$43.4K
    99496The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires high–level medical decision making, contact…180$160$28.8K
    G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit160$120$20.1K
    G0179Physician 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…480$30$14.8K

    Showing 1–10 of 33

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 33 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    33 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    9930921,840240$70$35K
    9935057568090$120$24.4K
    993081231,600170$50$23.8K
    993491441,050100$80$19.5K
    992141,09432,500110$80$17.6K
    99490611,520180$40$16.2K
    G01811237060$70$12.6K
    G04391,0467,11060$120$10.6K
    9930622984050$130$9.9K
    9921311,02929,79070$60$8.4K

    Showing 1–10 of 33

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Sergio Cantu, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Mark LeFLDiagnostic Radiology Physician$10.7M$0
    April LopezTXFamily Nurse Practitioner$6.7M$0
    Rohit AdyanthayaVAOphthalmology Physician$4.1M$0
    Ricky AlanizTXOptometrist$77.9K$3.7M
    Jeremiah BrownTXRetina Specialist (Ophthalmology) Physician$3.7M$0
    Joseph KhawlyTXOphthalmology Physician$3.2M$0
    Howard MartinTXDermatopathology (Pathology) Physician$3M$0
    Moises ChicaTXRetina Specialist (Ophthalmology) Physician$2.8M$0
    Andres SorianoFLMedical Oncology Physician$2.4M$0
    Darrell BaskinTXOphthalmology Physician$2.2M$0

    Nearby Providers

    Other providers in the same ZIP code as Sergio Cantu, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    First Home Healthcare, LLCTXHome Health Agency$0$56.9M
    Gold Horses, LLCTXHome Health Agency$0$54.2M
    Lando, Inc.TXHome Health Agency$0$53.2M
    Mi Casa Nursing Services Home Health LLCTXHome Health Agency$0$47.5M
    Community Action Corporation Of South TexasTXEarly Intervention Provider Agency$0$35.2M
    Saldivar Coastal Services, Inc.TXPersonal Care Attendant$0$25M
    Kristen SosaTXFamily Nurse Practitioner$1.5M$0
    Suraj KamatTXCardiovascular Disease Physician$569.3K$0
    Carlos ElizondoTXFamily Medicine Physician$366.6K$0
    Usman QureshiTXCardiovascular Disease Physician$219.5K$0

    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.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Texas Distribution
    Sergio Cantu — 8 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Texas