Shenandoah Nephrology, PLC

Shenandoah Nephrology, PLC was paid $273K by Medicaid between Jul 2018 and Oct 2024, across 9 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 — 64% of everything it billed.

33Billing provider infoSHENANDOAH NEPHROLOGY, PLC
ROCKINGHAM, VA 22801

33aNPI1174013171assigned 05/15/2018

33bProvider typeNephrology Physician

28Total paid$273K

24GClaims4,799

24DCodes billed9

24AFirst – last monthJul 2018 – Oct 2024

Compared with peers

Next to other Nephrology Physician providers in Virginia

Rank by total paid#15 of 42

Median peer was paid$72K

This provider vs. median3.8×

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	78	$2K
2019	907	$28K
2020	861	$36K
2021	609	$39K
2022	861	$58K
2023	765	$66K
2024incomplete	718	$44K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
90960	End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits	64%	2,467	2,105	$174K
90961		18%	813	715	$51K
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	15%	984	802	$40K
99215	Doctor's office visit, returning patient (complex)Prolong outpt/office vis	<1%	32	27	$2K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	<1%	109	90	$2K
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%	295	265	$1K
99223	Prolong inpt eval add15 m	<1%	15	15	$1K
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	<1%	54	29	$1K
90935	Hemodialysis procedure with single evaluation by a physician	<1%	30	13	$572.07

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 officialOVERBY, TERRY (DOCTOR)