Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Physician

Clinical Renal Associates, LLC

Clinical Renal Associates, LLC was paid $1.06M by Medicaid between Jan 2018 and Nov 2024, across 10 billing codes. Its largest line is 99232, hospital visit by a doctor, follow-up day — 47% of everything it billed.

33Billing provider infoCLINICAL RENAL ASSOCIATES, LLC
UPLAND, PA 19013
33aNPI1689620254assigned 05/25/2006
33bProvider typeNephrology Physician
28Total paid$1.06M
24GClaims28,752
24DCodes billed10
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers

Next to other Nephrology Physician providers in Pennsylvania

Rank by total paid#3 of 149
Median peer was paid$5K
This provider vs. median234×

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

$0$20K$40K$60K2018201920202021202220232024
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
YearClaimsPaid
2018805$1K
201921$0.00
20201,146$23K
20215,684$169K
20226,902$277K
20237,084$281K
2024incomplete7,110$307K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99232 Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity 47% 16,774 6,618 $498K
90960 End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits 27% 3,766 3,395 $281K
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 13% 5,049 4,853 $142K
99233 Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m 7.2% 1,941 881 $76K
99223 Prolong inpt eval add15 m 3.8% 552 520 $40K
99215 Doctor's office visit, returning patient (complex)Prolong outpt/office vis 1.2% 281 266 $12K
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% 339 323 $6K
90961 <1% 13 13 $1K
99231 Subsequent hospital care, per day, straightforward or low complexity <1% 22 12 $388.52
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% 15 15 $33.00

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 officialMARCUS, ROY (CHIEF OPERATING OFFICER)