Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

BALBOA NEPHROLOGY MEDICAL GROUP, INC.

NPI: 1316997505 · SAN DIEGO, CA 92123 · Surgery Physician · NPI assigned 05/11/2006

$25.86M
Total Medicaid Paid
402,139
Total Claims
296,796
Beneficiaries
54
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialEDELSTEIN, SHAUN (CFO)
NPI Enumeration Date05/11/2006

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 43,981 $2.95M
2019 52,063 $3.20M
2020 57,441 $3.50M
2021 61,601 $4.03M
2022 61,487 $3.84M
2023 68,535 $4.23M
2024 57,031 $4.12M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
90960 End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits 112,085 111,703 $12.70M
99232 Subsequent hospital care, per day, moderate complexity 111,094 37,623 $2.73M
36902 5,219 5,159 $2.64M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 68,324 65,947 $2.16M
99233 Prolong inpt eval add15 m 38,598 15,444 $1.08M
36905 891 835 $971K
90961 9,237 9,198 $904K
90966 6,291 6,276 $732K
99223 Prolong inpt eval add15 m 8,985 8,671 $483K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 9,517 9,397 $211K
90935 Hemodialysis procedure with single evaluation by a physician 5,935 3,108 $192K
36901 575 571 $156K
36215 1,404 1,295 $155K
75710 1,638 1,508 $144K
99152 6,124 5,822 $122K
99222 Initial hospital care, per day, moderate complexity 1,716 1,668 $81K
93985 500 497 $77K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 1,154 1,150 $73K
36589 535 527 $50K
36907 320 316 $39K
99215 Prolong outpt/office vis 651 562 $23K
99231 Subsequent hospital care, per day, straightforward or low complexity 1,939 745 $23K
90962 309 307 $16K
99457 1,447 1,446 $13K
99458 1,001 1,000 $13K
37225 12 12 $11K
77001 250 232 $9K
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) 2,513 2,477 $7K
99205 Prolong outpt/office vis 92 92 $7K
36821 37 37 $7K
99454 525 524 $6K
99442 280 276 $5K
99153 Mod sedat endo service >5yrs 338 325 $3K
90970 304 55 $2K
36558 12 12 $1K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 26 26 $1K
93925 40 39 $1K
J0885 Injection, epoetin alfa, (for non-esrd use), 1000 units 73 50 $1K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 299 190 $918.96
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 244 202 $774.02
99497 62 62 $673.37
76937 52 52 $577.55
75625 12 12 $546.23
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 30 30 $454.25
99349 25 25 $378.67
J2250 Injection, midazolam hydrochloride, per 1 mg 189 170 $346.08
99453 129 129 $325.78
93923 13 13 $301.33
0061U 127 64 $110.44
J3010 Injection, fentanyl citrate, 0.1 mg 82 73 $86.54
G9500 Radiation exposure indices documented in final report for procedure using fluoroscopy 537 508 $0.00
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 311 298 $0.00
90756 19 19 $0.00
99443 17 17 $0.00