Renal Physician Associates of Winchester PLC

Renal Physician Associates of Winchester PLC was paid $220K by Medicaid between Jan 2018 and Dec 2024, across 7 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 — 63% of everything it billed.

33Billing provider infoRENAL PHYSICIAN ASSOCIATES OF WINCHESTER PLC
WINCHESTER, VA 22601

33aNPI1528142577assigned 10/25/2006

33bProvider typeMedical Specialty Clinic/Center

28Total paid$220K

24GClaims4,811

24DCodes billed7

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Medical Specialty Clinic/Center providers in Virginia

Rank by total paid#2 of 19

Median peer was paid$18K

This provider vs. median12×

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	518	$13K
2019	1,219	$39K
2020	298	$15K
2021	641	$36K
2022	706	$51K
2023	748	$35K
2024incomplete	681	$31K

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	63%	1,894	1,592	$138K
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	20%	1,169	999	$44K
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	16%	1,481	489	$34K
90935	Hemodialysis procedure with single evaluation by a physician	<1%	82	38	$2K
99223	Prolong inpt eval add15 m	<1%	18	13	$1K
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%	149	133	$425.63
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%	18	14	$394.16

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 officialSISSON, DAVID (PRESIDENT)