Physician
Nephrology Associates, INC
Nephrology Associates, INC was paid $160K by Medicaid between Jan 2018 and Mar 2023, across 13 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 — 51% of everything it billed.
33Billing provider infoNEPHROLOGY ASSOCIATES, INC
WHEELING, WV 26003
WHEELING, WV 26003
33aNPI1457430134assigned 11/03/2006
33bProvider typeNephrology Physician
28Total paid$160K
24GClaims5,394
24DCodes billed13
24AFirst – last monthJan 2018 – Mar 2023
Compared with peers
Next to other Nephrology Physician providers in West Virginia
Rank by total paid#7 of 14
Median peer was paid$89K
This provider vs. median1.8×
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 | 933 | $32K | |
| 2019 | 966 | $28K | |
| 2020 | 1,493 | $49K | |
| 2021 | 1,386 | $38K | |
| 2022 | 508 | $10K | |
| 2023 | 108 | $4K |
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 | 51% | 2,441 | 2,342 | $82K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 34% | 1,962 | 800 | $55K |
| 99223 | Prolong inpt eval add15 m | 4.9% | 127 | 119 | $8K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 3.2% | 186 | 79 | $5K |
| 99222 | Initial hospital care, per day, moderate complexity | 1.9% | 112 | 101 | $3K |
| 90961 | 1.9% | 83 | 82 | $3K | |
| 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 | 1.6% | 80 | 76 | $3K |
| 90935 | Hemodialysis procedure with single evaluation by a physician | <1% | 37 | 24 | $1K |
| 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% | 17 | 14 | $897.55 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 232 | 225 | $0.00 |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 30 | 30 | $0.00 |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 73 | 71 | $0.00 |
1 more codes
| G9903 | Patient screened for tobacco use and identified as a tobacco non-user | 0% | 14 | $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 officialMARKER, MARINE (PRESIDENT)