Physician
The Nephrology Group, INC.
The Nephrology Group, INC. was paid $6.21M by Medicaid between Jan 2018 and Dec 2024, across 96 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 — 53% of everything it billed.
33Billing provider infoTHE NEPHROLOGY GROUP, INC.
FRESNO, CA 93720
FRESNO, CA 93720
33aNPI1205906229assigned 11/08/2006
33bProvider typeEndocrinology, Diabetes & Metabolism Physician
28Total paid$6.21M
24GClaims295,655
24DCodes billed96
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Endocrinology, Diabetes & Metabolism Physician providers in California
Rank by total paid#1 of 158
Median peer was paid$17K
This provider vs. median362×
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 | 31,302 | $335K | |
| 2019 | 37,573 | $297K | |
| 2020 | 40,729 | $585K | |
| 2021 | 39,279 | $780K | |
| 2022 | 43,209 | $1.22M | |
| 2023 | 52,713 | $1.48M | |
| 2024incomplete | 50,850 | $1.51M |
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 | 53% | 60,517 | 59,941 | $3.26M |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 9.9% | 64,961 | 23,910 | $617K |
| 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 | 9.5% | 25,593 | 25,038 | $591K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 8.2% | 24,542 | 10,104 | $509K |
| 90961 | 6.7% | 6,451 | 6,423 | $418K | |
| 90935 | Hemodialysis procedure with single evaluation by a physician | 2.0% | 9,819 | 5,655 | $122K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.0% | 12,211 | 11,841 | $122K |
| 90966 | 1.8% | 2,506 | 2,501 | $109K | |
| 99223 | Prolong inpt eval add15 m | 1.4% | 2,704 | 2,640 | $87K |
| 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% | 1,504 | 1,487 | $60K |
| 36902 | <1% | 988 | 966 | $41K | |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | <1% | 2,967 | 2,478 | $36K |
84 more codes
| 83970 | <1% | 3,596 | $22K | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 3,798 | $17K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 2,792 | $17K |
| 80053 | Comprehensive metabolic panel | <1% | 6,352 | $14K |
| 99254 | <1% | 561 | $14K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 374 | $11K |
| 82610 | <1% | 5,120 | $10K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 767 | $10K |
| 36901 | <1% | 402 | $8K | |
| 36005 | <1% | 225 | $7K | |
| 93985 | <1% | 296 | $7K | |
| 90962 | <1% | 177 | $7K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 4,072 | $6K |
| 83735 | <1% | 6,316 | $6K | |
| 82570 | <1% | 5,205 | $5K | |
| 82607 | <1% | 1,133 | $5K | |
| 84100 | <1% | 6,146 | $5K | |
| 82746 | <1% | 1,256 | $4K | |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 114 | $4K |
| 82728 | <1% | 1,154 | $4K | |
| 84156 | <1% | 4,670 | $4K | |
| 36589 | <1% | 389 | $3K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 214 | $3K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 3,350 | $3K |
| 99205 | Prolong outpt/office vis | <1% | 342 | $3K |
| 83550 | <1% | 1,574 | $3K | |
| 85046 | <1% | 2,107 | $3K | |
| 83540 | <1% | 1,575 | $2K | |
| 99443 | <1% | 212 | $2K | |
| 36903 | <1% | 13 | $2K | |
| 99442 | <1% | 290 | $2K | |
| 76770 | <1% | 437 | $2K | |
| 84550 | <1% | 1,100 | $2K | |
| 75820 | <1% | 97 | $2K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 219 | $1K |
| 75827 | <1% | 134 | $1K | |
| 90970 | <1% | 794 | $1K | |
| 90945 | <1% | 128 | $1K | |
| 99152 | <1% | 749 | $958.08 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 2,266 | $853.72 |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 754 | $846.70 |
| 0001A | <1% | 28 | $840.00 | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 105 | $830.62 |
| 99255 | <1% | 37 | $820.49 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 641 | $627.92 |
| 95251 | <1% | 477 | $581.73 | |
| 99426 | <1% | 90 | $562.64 | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,406 | $529.82 |
| 85027 | <1% | 1,508 | $491.62 | |
| 0002A | <1% | 14 | $480.00 | |
| 75710 | <1% | 179 | $316.53 | |
| 36216 | <1% | 31 | $262.30 | |
| 85045 | <1% | 169 | $257.63 | |
| 77001 | <1% | 12 | $235.16 | |
| 36215 | <1% | 21 | $233.71 | |
| 0011A | <1% | 16 | $203.28 | |
| 76937 | <1% | 229 | $186.58 | |
| 82043 | <1% | 1,757 | $172.45 | |
| 99427 | <1% | 37 | $166.20 | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 218 | $165.32 |
| 93931 | <1% | 33 | $157.43 | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 375 | $112.32 |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 116 | $101.90 |
| 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% | 386 | $101.26 |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 62 | $86.04 |
| 80061 | Lipid panel | <1% | 248 | $66.75 |
| 80069 | <1% | 368 | $40.28 | |
| 84439 | <1% | 51 | $31.64 | |
| 82948 | <1% | 140 | $24.67 | |
| 85014 | <1% | 131 | $16.85 | |
| 85018 | <1% | 132 | $16.21 | |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 146 | $9.79 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | <1% | 123 | $8.44 |
| 81000 | <1% | 70 | $6.92 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 14 | $3.91 |
| 76775 | <1% | 12 | $1.24 | |
| 86160 | 0% | 36 | $0.00 | |
| 76536 | 0% | 12 | $0.00 | |
| 99243 | 0% | 46 | $0.00 | |
| 99153 | Mod sedat endo service >5yrs | 0% | 15 | $0.00 |
| 80074 | 0% | 41 | $0.00 | |
| 99244 | Office or other outpatient consultation, moderate to high complexity | 0% | 45 | $0.00 |
| 93923 | 0% | 24 | $0.00 | |
| 90937 | 0% | 21 | $0.00 |
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 officialSU, STEVE (ASSISTANT SECRETARY)
| Provider | Location | Paid |
|---|---|---|
| The Nephrology Group, INC. Clinical Lab | Fresno, CA | $5K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.