Lerma, Edgar

Lerma, Edgar was paid $141K by Medicaid between Jan 2018 and Sep 2024, across 8 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 — 33% of everything it billed.

33Billing provider infoLERMA, EDGAR
EVERGREEN PARK, IL 60805

33aNPI1841279981assigned 01/16/2006

33bProvider typeNephrology Physician

28Total paid$141K

24GClaims5,050

24DCodes billed8

24AFirst – last monthJan 2018 – Sep 2024

Compared with peers

Next to other Nephrology Physician providers in Illinois

Rank by total paid#85 of 327

Median peer was paid$68K

This provider vs. median2.1×

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	740	$11K
2019	947	$24K
2020	1,410	$39K
2021	767	$29K
2022	683	$16K
2023	257	$13K
2024incomplete	246	$8K

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	33%	522	497	$47K
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	30%	2,909	985	$42K
90966		11%	300	292	$15K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	9.9%	413	164	$14K
99223	Prolong inpt eval add15 m	9.5%	319	292	$13K
90935	Hemodialysis procedure with single evaluation by a physician	4.3%	477	221	$6K
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	2.2%	78	68	$3K
99222	Initial hospital care, per day, moderate complexity	<1%	32	28	$727.32

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.