Physician
Southeastern CT Nephrology Assoc PC
Southeastern CT Nephrology Assoc PC was paid $818K by Medicaid between Jan 2018 and Nov 2024, across 25 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 — 45% of everything it billed.
33Billing provider infoSOUTHEASTERN CT NEPHROLOGY ASSOC PC
UNCASVILLE, CT 06382
UNCASVILLE, CT 06382
33aNPI1619031796assigned 12/21/2006
33bProvider typeNephrology Physician
28Total paid$818K
24GClaims28,218
24DCodes billed25
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Nephrology Physician providers in Connecticut
Rank by total paid#5 of 20
Median peer was paid$52K
This provider vs. median16×
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 | 5,920 | $131K | |
| 2019 | 4,742 | $146K | |
| 2020 | 4,356 | $140K | |
| 2021 | 3,187 | $105K | |
| 2022 | 3,373 | $95K | |
| 2023 | 3,868 | $114K | |
| 2024incomplete | 2,772 | $87K |
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 | 45% | 6,044 | 5,731 | $371K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 18% | 9,852 | 4,315 | $146K |
| 90961 | 13% | 1,708 | 1,641 | $108K | |
| 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 | 8.7% | 3,884 | 3,716 | $71K |
| 90966 | 4.8% | 576 | 535 | $39K | |
| 90935 | Hemodialysis procedure with single evaluation by a physician | 3.9% | 1,296 | 695 | $32K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 3.6% | 1,248 | 646 | $29K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.2% | 1,564 | 1,481 | $18K |
| 99223 | Prolong inpt eval add15 m | <1% | 43 | 40 | $2K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 64 | 61 | $2K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 40 | 39 | $1K |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 52 | 49 | $150.58 |
13 more codes
| 81003 | <1% | 14 | $19.26 | |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 251 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 430 | $0.00 |
| G8783 | Normal blood pressure reading documented, follow-up not required | 0% | 37 | $0.00 |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | 0% | 57 | $0.00 |
| G8477 | Most recent blood pressure has a systolic measurement of >= 140 mmhg and/or a diastolic measurement of >= 90 mmhg | 0% | 13 | $0.00 |
| 3062F | 0% | 14 | $0.00 | |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 355 | $0.00 |
| 1036F | 0% | 373 | $0.00 | |
| G8950 | Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented | 0% | 250 | $0.00 |
| 1123F | 0% | 13 | $0.00 | |
| 3066F | 0% | 25 | $0.00 | |
| 3060F | 0% | 15 | $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 officialGINSBERG, JAY (PHYSICIAN)