Nephrology Associates of South Miami PA

Nephrology Associates of South Miami PA was paid $1.19M by Medicaid between Jan 2018 and Nov 2024, across 12 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 — 44% of everything it billed.

33Billing provider infoNEPHROLOGY ASSOCIATES OF SOUTH MIAMI PA
MIAMI, FL 33173

33aNPI1811943434assigned 05/25/2006

33bProvider typeNephrology Physician

28Total paid$1.19M

24GClaims46,996

24DCodes billed12

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Nephrology Physician providers in Florida

Rank by total paid#8 of 188

Median peer was paid$28K

This provider vs. median42×

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	2,088	$20K
2019	7,589	$184K
2020	8,162	$204K
2021	10,017	$259K
2022	7,461	$194K
2023	6,975	$203K
2024incomplete	4,704	$121K

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	44%	10,567	7,994	$522K
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	32%	26,141	11,679	$378K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	10%	5,165	2,177	$122K
99223	Prolong inpt eval add15 m	8.4%	2,470	1,820	$99K
90961		2.2%	514	405	$26K
99222	Initial hospital care, per day, moderate complexity	1.4%	670	489	$16K
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	<1%	454	338	$8K
90935	Hemodialysis procedure with single evaluation by a physician	<1%	657	328	$8K
99291	Critical care, evaluation and management of the critically ill patient, first 30-74 minutes	<1%	119	39	$5K
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%	202	151	$2K
99231	Subsequent hospital care, per day, straightforward or low complexity	<1%	21	16	$290.23
99442		<1%	16	13	$35.30

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 officialBUSSE, JORGE (PRESIDENT)