Providers

DARIA BABINEAUX, M.D.

NPI 1508861196, individual, Rio Grande City, TX, Pediatrics

4
Evidence tier
structure or single-organization volume
  • Hours beyond a day in 7 months, but with up to 2521 patients a month across 3 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
score 51 of 100, rank 8798, $1.7M at stake

Hours billed per day

Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.

monthwhat was foundhours per day, lower boundhours per day, at pricehours per day, conservativeper working daypatientsbilling organizationscodespaid
Jan 2022More hours than a day holds, even counting one unit per claim line25.325.216.824.81809299203 99213$84K
Aug 2022More hours than a day holds, even counting one unit per claim line24.322.214.819.91916297802 99203 99213$73K
Sep 2022More hours than a day holds, even counting one unit per claim line24.023.715.821.51674299203 99213$76K
Oct 2022More hours than a day holds, even counting one unit per claim line29.726.717.826.32234297802 99203 99213$89K
Aug 2023More hours than a day holds, even counting one unit per claim line28.323.215.520.82521299203 99213 99406$80K
Oct 2023More hours than a day holds, even counting one unit per claim line26.623.115.421.72066299203 99213 99406$79K
Nov 2023More hours than a day holds, even counting one unit per claim line25.121.014.019.11914299203 99213 99406$70K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameDARIA BABINEAUX, M.D.
TypeIndividual, sole proprietor
StatusActive
NPI issuedJune 20, 2005, last updated January 29, 2026
Practice location214 CHAPARRAL BLVD, Rio Grande City, TX 78582-4613, 956-263-1830
Mailing address1673 E SAN BENITO ST STE D, Rio Grande City, TX 78582-3482
Specialties
Specialist (174400000X, license ME87343 FL)
Pediatrics (208000000X, primary, license L6771 TX)

Procedures billed

The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.

Medicaid, largest codes
codewhat it ispaidshareper patient-monthtypicalrank among providers
T1015Medicaid service code$11.2M64%$347$182 (top 5% from $488)88th percentile
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$2.1M12%$41$44 (top 5% from $110)46th percentile
87811Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)$982K6%$35$33 (top 5% from $45)59th percentile
S8301Medicaid service code$495K3%$20$7.59 (top 5% from $33)86th percentile
99393Medicaid service code$405K2%$80$78 (top 5% from $121)54th percentile
87804Detection test by immunoassay with direct visual observation for influenza virus$368K2%$26$22 (top 5% from $33)69th percentile
87880Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)$343K2%$13$12 (top 5% from $18)56th percentile
99392Medicaid service code$342K2%$75$78 (top 5% from $124)45th percentile

In this area

5 providers in Starr County, TX carry an indicator in the public record, with $2.8M at stake between them. The most common is more hours than a day holds, on 4 of them, followed by paid after a public list action on 1. 1 is tier 1: documented action, then payment.

tierproviderat stakewhy
1CELIA ZUNIGA
Rio Grande City, TX, ranked 249
$19K
  • Listed on the Medicare revocation list since February 26, 2014.
  • Medicaid still paid claims in 5 later months, $18,657 in total.
4ARTEMIO GARCIA
Rio Grande City, TX, ranked 9393
$269K
  • Hours beyond a day in 5 months, but with up to 569 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
5MARIO RODRIGUEZ
Rio Grande City, TX, ranked 10059
$1.3M
  • Medicaid dollars per patient on code 99444 ($235 per patient-month) sit in the top 5% of every provider billing that code.
5MARIA VALDEZ
Roma, TX, ranked 10944
$1.2M
5YVETTE BELTRAN DBA LOS GIRASOLES ADULT DAY
Rio Grande City, TX, ranked 11838
$28K

Recent enforcement in TX

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJCivil settlementAug 26, 2026
Dallas medical clinic to pay $7.5 million to resolve COVID-19 testing overbilling allegations
Aymancare billed the federal government's HRSA Uninsured Program for separate evaluation and management services in addition to COVID-19 specimen collection and testing at pop-up testing sites when no such separate services were performed.
DOJConvictedAug 12, 2026
Scammer pharmacist guilty in $20 million healthcare kickback scheme
Thomas paid over $2 million in kickbacks to the owner of a Houston clinic in exchange for referrals of DOL-OWCP insured patients prescribed high-reimbursement compounded medications, which his pharmacy then billed to DOL-OWCP, receiving more than $20 million in reimbursements.
DOJIndictedJun 24, 2026
U.S. Attorney Announces Major Health Care Fraud Cases in Western District of Texas
Charles is alleged to have received illegal kickbacks for referring patients to San Antonio area hospice companies, causing over $9 million in Medicare claims, while Dr. Duncan settled allegations of billing Medicare and TRICARE for an unapproved amniotic-based product and Trevor's Place settled allegations of submitting inflated TRICARE claims for services not provided.
DOJIndictedJun 23, 2026
Nine charged in SDTX as part of national health care fraud takedown
Nine defendants were indicted in the Southern District of Texas for operating pill mill clinics and a pharmacy that unlawfully distributed controlled substances, billing Medicaid $16 million for mental health services for minors that did not occur, and billing Medicare and TRICARE approximately $906 million for medically unnecessary amniotic wound allografts procured through kickbacks.
DOJChargedJun 23, 2026
Northern District of Texas Charges 13 Health Care Fraudsters for Loss Over $360 Million
Thirteen defendants in the Northern District of Texas were charged in seven cases involving more than $365 million in fraudulent billing to federally-funded programs and other insurers, including laboratory and genetic testing claims procured through kickbacks, transcranial magnetic stimulation treatments billed to TRICARE, medically unnecessary EEG testing, and hospice services never provided.

Referral packet

The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.

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