Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Lynchburg Nephrology Physicians PLLC

Lynchburg Nephrology Physicians PLLC was paid $1.20M by Medicaid between Jan 2018 and Nov 2024, across 18 billing codes. Its largest line is 90960, End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits — 56% of everything it billed.

33Billing provider infoLYNCHBURG NEPHROLOGY PHYSICIANS PLLC
LYNCHBURG, VA 24501
33aNPI1053498071assigned 11/01/2006
33bProvider typeSpecialist
28Total paid$1.20M
24GClaims33,899
24DCodes billed18
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers

Next to other Specialist providers in Virginia

Rank by total paid#23 of 231
Median peer was paid$47K
This provider vs. median26×

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

$0$10K$20K$30K2018201920202021202220232024
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
YearClaimsPaid
20186,735$124K
20196,233$147K
20204,450$145K
20214,390$192K
20224,925$243K
20234,011$207K
2024incomplete3,155$146K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
90960 End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits 56% 11,487 9,380 $675K
99232 Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity 11% 7,675 3,259 $132K
90935 Hemodialysis procedure with single evaluation by a physician 10% 6,882 3,291 $122K
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 7.0% 2,343 1,919 $84K
90961 6.9% 1,498 1,260 $83K
99223 Prolong inpt eval add15 m 6.6% 1,537 1,358 $79K
99231 Subsequent hospital care, per day, straightforward or low complexity 1.1% 960 481 $13K
99222 Initial hospital care, per day, moderate complexity <1% 767 443 $9K
99233 Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m <1% 144 84 $4K
99204 Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity <1% 13 12 $588.90
99203 Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity <1% 15 14 $348.57
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) <1% 84 80 $315.79
6 more codes
99213 Doctor's office visit, returning patient (routine) <1% 14 $203.93
36415 Collection of venous blood by venipuncture <1% 244 $89.92
80069 <1% 108 $89.91
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 97 $80.78
83970 <1% 16 $47.69
83735 <1% 15 $15.70

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 officialRUNIONS, AMANDA (PRACTICE MANAGER)