Physician
Nephrology Associates PA
Nephrology Associates PA was paid $5.74M by Medicaid between Jan 2018 and Dec 2024, across 39 billing codes. Its largest line is 99232, hospital visit by a doctor, follow-up day — 25% of everything it billed.
33Billing provider infoNEPHROLOGY ASSOCIATES PA
NEWARK, DE 19713
NEWARK, DE 19713
33aNPI1407805203assigned 05/09/2006
33bProvider typeNephrology Physician
28Total paid$5.74M
24GClaims159,745
24DCodes billed39
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Nephrology Physician providers in Delaware
Rank by total paid#1 of 5
Median peer was paid$822K
This provider vs. median7.0×
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 | 22,610 | $285K | |
| 2019 | 27,539 | $540K | |
| 2020 | 24,114 | $1.12M | |
| 2021 | 24,086 | $1.07M | |
| 2022 | 22,991 | $1.12M | |
| 2023 | 22,776 | $1.01M | |
| 2024incomplete | 15,629 | $596K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 25% | 55,841 | 12,906 | $1.44M |
| 90960 | End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits | 21% | 23,296 | 19,760 | $1.20M |
| 99223 | Prolong inpt eval add15 m | 8.9% | 6,855 | 5,810 | $513K |
| 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 | 7.7% | 12,060 | 10,435 | $445K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 7.2% | 8,754 | 3,151 | $412K |
| 36902 | 5.9% | 1,483 | 1,277 | $337K | |
| 90935 | Hemodialysis procedure with single evaluation by a physician | 5.4% | 15,390 | 4,559 | $310K |
| 90961 | 4.2% | 4,541 | 3,928 | $241K | |
| 99222 | Initial hospital care, per day, moderate complexity | 3.7% | 5,156 | 4,154 | $211K |
| 90966 | 2.3% | 2,717 | 2,355 | $131K | |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 1.9% | 1,722 | 1,505 | $111K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.8% | 3,517 | 3,126 | $101K |
27 more codes
| 99204 | Doctor's office visit, new patient (more involved) | 1.2% | 933 | $70K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | 1.0% | 4,892 | $59K |
| 36558 | <1% | 394 | $44K | |
| Q5106 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units | <1% | 1,028 | $28K |
| 36589 | <1% | 311 | $15K | |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | <1% | 826 | $13K |
| 90962 | <1% | 300 | $11K | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 2,917 | $11K |
| 77001 | <1% | 644 | $9K | |
| 99442 | <1% | 242 | $7K | |
| 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% | 1,317 | $6K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,724 | $4K |
| 99152 | <1% | 318 | $3K | |
| 99443 | <1% | 140 | $3K | |
| 81002 | <1% | 1,101 | $2K | |
| 90970 | <1% | 99 | $1K | |
| 99205 | Prolong outpt/office vis | <1% | 14 | $1K |
| 90945 | <1% | 31 | $1K | |
| 99153 | Mod sedat endo service >5yrs | <1% | 318 | $1K |
| 99441 | <1% | 39 | $601.73 | |
| 76937 | <1% | 128 | $475.51 | |
| 36415 | Collection of venous blood by venipuncture | 0% | 266 | $0.00 |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 0% | 77 | $0.00 |
| 80069 | 0% | 148 | $0.00 | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | 0% | 17 | $0.00 |
| 82570 | 0% | 106 | $0.00 | |
| 84156 | 0% | 83 | $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 officialGAVIN, MARTIN (PRESIDENT)