Physician
South Mountain Nephrology, LLC
South Mountain Nephrology, LLC was paid $115K by Medicaid between Jan 2018 and Aug 2023, across 7 billing codes. Its largest line is 99232, hospital visit by a doctor, follow-up day — 49% of everything it billed.
33Billing provider infoSOUTH MOUNTAIN NEPHROLOGY, LLC
BELLEVILLE, NJ 07109
BELLEVILLE, NJ 07109
33aNPI1851403927assigned 08/31/2006
33bProvider typeNephrology Physician
28Total paid$115K
24GClaims6,340
24DCodes billed7
24AFirst – last monthJan 2018 – Aug 2023
Compared with peers
Next to other Nephrology Physician providers in New Jersey
Rank by total paid#36 of 117
Median peer was paid$38K
This provider vs. median3.0×
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 | 670 | $14K | |
| 2019 | 503 | $10K | |
| 2020 | 1,553 | $28K | |
| 2021 | 1,524 | $29K | |
| 2022 | 1,201 | $21K | |
| 2023 | 889 | $12K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 49% | 4,202 | 1,638 | $56K |
| 90960 | End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits | 34% | 1,082 | 1,069 | $39K |
| 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 | 12% | 567 | 560 | $14K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 4.5% | 357 | 345 | $5K |
| 99223 | Prolong inpt eval add15 m | <1% | 12 | 12 | $380.79 |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 14 | 14 | $64.60 |
| 99072 | 0% | 106 | 105 | $0.00 |
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 officialDEFRANCO, PENNY (PRESIDENT)