The Nephrology Group, INC.
The Nephrology Group, INC. was paid $1.14M by Medicaid between Jan 2018 and May 2021, across 22 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 — 55% of everything it billed.
MERCED, CA 95348
Next to other Nephrology Physician providers in California
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.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 6,071 | $282K | |
| 2019 | 6,156 | $336K | |
| 2020 | 5,214 | $346K | |
| 2021 | 2,084 | $179K |
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 | 55% | 5,319 | 5,312 | $633K |
| 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 | 16% | 4,013 | 3,967 | $186K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 12% | 3,956 | 1,447 | $134K |
| 99223 | Prolong inpt eval add15 m | 5.4% | 1,088 | 975 | $62K |
| 90966 | 4.9% | 585 | 585 | $57K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.0% | 898 | 896 | $22K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 1.6% | 943 | 459 | $18K |
| 90935 | Hemodialysis procedure with single evaluation by a physician | <1% | 322 | 166 | $8K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | <1% | 96 | 96 | $7K |
| 90961 | <1% | 55 | 55 | $5K | |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | <1% | 19 | 13 | $3K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 301 | 208 | $2K |
10 more codes
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 25 | $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% | 125 | $1K |
| 82962 | <1% | 1,245 | $1K | |
| 90937 | <1% | 37 | $996.02 | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 15 | $721.72 |
| 99205 | Prolong outpt/office vis | <1% | 12 | $248.10 |
| 85018 | <1% | 303 | $237.58 | |
| 99423 | <1% | 19 | $143.00 | |
| 99422 | <1% | 17 | $76.15 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 132 | $0.21 |
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.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| Pinnacle Interventional and Vascular Care | Oklahoma City, OK | $708.69 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.