Capital Nephrology Medical Group
Capital Nephrology Medical Group was paid $2.09M by Medicaid between Jan 2018 and Nov 2024, across 25 billing codes. Its largest line is 90961, — 58% of everything it billed.
33Billing provider infoCAPITAL NEPHROLOGY MEDICAL GROUP
SACRAMENTO, CA 95825
SACRAMENTO, CA 95825
33aNPI1235150400assigned 07/22/2006
33bProvider typeSpecialist
28Total paid$2.09M
24GClaims63,259
24DCodes billed25
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Specialist providers in California
Rank by total paid#113 of 1,230
Median peer was paid$51K
This provider vs. median41×
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 | 8,198 | $321K | |
| 2019 | 9,839 | $329K | |
| 2020 | 9,515 | $288K | |
| 2021 | 8,460 | $265K | |
| 2022 | 8,070 | $286K | |
| 2023 | 10,169 | $306K | |
| 2024incomplete | 9,008 | $292K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 90961 | 58% | 29,029 | 28,847 | $1.22M | |
| 90962 | 13% | 7,444 | 7,391 | $276K | |
| 36902 | 7.7% | 1,339 | 1,284 | $161K | |
| 90960 | End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits | 7.5% | 5,087 | 5,058 | $157K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 5.7% | 8,761 | 4,152 | $118K |
| 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 | 3.0% | 4,915 | 4,867 | $63K |
| 90966 | 2.2% | 1,422 | 1,408 | $46K | |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 1.1% | 922 | 549 | $23K |
| 99152 | <1% | 1,963 | 1,849 | $7K | |
| 93985 | <1% | 114 | 113 | $6K | |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 223 | 222 | $4K |
| 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% | 896 | 891 | $4K |
13 more codes
| 90935 | Hemodialysis procedure with single evaluation by a physician | <1% | 218 | $3K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 56 | $2K |
| 93990 | <1% | 67 | $1K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 80 | $561.50 |
| 99223 | Prolong inpt eval add15 m | <1% | 41 | $520.65 |
| 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% | 411 | $316.83 |
| 99442 | <1% | 96 | $146.69 | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 12 | $70.42 |
| 99153 | Mod sedat endo service >5yrs | <1% | 46 | $60.53 |
| 99443 | <1% | 27 | $27.51 | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 57 | $9.54 |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 21 | $0.61 |
| G9745 | Documented reason for not screening or recommending a follow-up for high blood pressure | 0% | 12 | $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 officialTANI, CHRISTINA (ACCOUNTS MANAGER)