Physician
The Nephrology Group PA
The Nephrology Group PA was paid $1.17M by Medicaid between Jan 2018 and Nov 2024, across 11 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 — 32% of everything it billed.
33Billing provider infoTHE NEPHROLOGY GROUP PA
WEST ORANGE, NJ 07052
WEST ORANGE, NJ 07052
33aNPI1518934207assigned 03/02/2006
33bProvider typeNephrology Physician
28Total paid$1.17M
24GClaims52,229
24DCodes billed11
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Nephrology Physician providers in New Jersey
Rank by total paid#6 of 117
Median peer was paid$38K
This provider vs. median31×
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 | 4,970 | $143K | |
| 2019 | 7,431 | $178K | |
| 2020 | 7,377 | $173K | |
| 2021 | 7,752 | $177K | |
| 2022 | 7,396 | $168K | |
| 2023 | 9,048 | $172K | |
| 2024incomplete | 8,255 | $157K |
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 | 32% | 8,938 | 8,502 | $374K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 28% | 22,239 | 9,944 | $331K |
| 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 | 17% | 7,870 | 7,478 | $201K |
| 90935 | Hemodialysis procedure with single evaluation by a physician | 11% | 7,673 | 3,521 | $131K |
| 99222 | Initial hospital care, per day, moderate complexity | 7.1% | 3,918 | 3,627 | $83K |
| 99205 | Prolong outpt/office vis | 1.9% | 464 | 440 | $23K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 1.3% | 589 | 560 | $15K |
| 90961 | <1% | 242 | 211 | $7K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 213 | 142 | $2K |
| 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% | 43 | 43 | $973.98 |
| 36415 | Collection of venous blood by venipuncture | <1% | 40 | 39 | $115.74 |
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 officialGOLDBLAT, MELVIN (PRESIDENT)