SOUTHEAST RENAL GROUP PSC
NPI: 1821413527
· SANTA ISABEL, PR 00757
· General Practice Physician
· NPI assigned 03/04/2014
$143K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: ORTIZ HEREDIA, LUIS
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
140 |
$13K |
| 2019 |
157 |
$21K |
| 2020 |
232 |
$46K |
| 2021 |
12 |
$2K |
| 2022 |
54 |
$2K |
| 2023 |
12 |
$3K |
| 2024 |
191 |
$55K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90960 |
End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits |
542 |
447 |
$122K |
| 90961 |
|
166 |
161 |
$18K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
27 |
13 |
$1K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
27 |
13 |
$765.76 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
36 |
35 |
$159.96 |