Cumberland Kidney Specialist

Cumberland Kidney Specialist was paid $185K by Medicaid between Jan 2018 and Dec 2024, across 28 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 37% of everything it billed.

33Billing provider infoCUMBERLAND KIDNEY SPECIALIST
COOKEVILLE, TN 38501

33aNPI1922248756assigned 03/06/2009

33bProvider typeMedical Specialty Clinic/Center

28Total paid$185K

24GClaims20,091

24DCodes billed28

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Medical Specialty Clinic/Center providers in Tennessee

Rank by total paid#5 of 15

Median peer was paid$56K

This provider vs. median3.3×

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	978	$15K
2019	2,401	$18K
2020	2,061	$20K
2021	3,061	$33K
2022	2,919	$28K
2023	4,348	$32K
2024incomplete	4,323	$39K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
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	37%	7,075	4,593	$68K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	20%	3,656	940	$36K
90960	End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits	17%	2,597	1,538	$31K
90966		8.3%	1,266	781	$15K
99215	Doctor's office visit, returning patient (complex)Prolong outpt/office vis	6.6%	1,168	755	$12K
99223	Prolong inpt eval add15 m	5.5%	632	363	$10K
99205	Prolong outpt/office vis	2.4%	130	97	$4K
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	<1%	343	57	$2K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established)	<1%	664	449	$877.66
85025	Blood count; complete (CBC), automated, and automated differential WBC count	<1%	534	381	$779.15
99490	Ccm add 20min	<1%	346	298	$648.67
82306	Vitamin D; 25 hydroxy, includes fraction(s), if performed	<1%	109	70	$632.70

16 more codes

99204	Doctor's office visit, new patient (more involved)	<1%	17	$558.95
80053	Comprehensive metabolic panel	<1%	337	$538.20
99222	Initial hospital care, per day, moderate complexity	<1%	57	$534.60
83735		<1%	301	$401.31
84100		<1%	273	$184.61
90970		<1%	64	$97.15
36415	Collection of venous blood by venipuncture	<1%	275	$90.19
84443	Thyroid stimulating hormone (TSH)	<1%	15	$80.73
82728		<1%	15	$71.12
99213	Doctor's office visit, returning patient (routine)	<1%	21	$42.98
81002		<1%	78	$39.45
83540		<1%	15	$36.08
84550		<1%	22	$34.65
99491	Ccm add 20min	<1%	19	$34.08
83970		<1%	47	$33.72
80069		<1%	15	$6.30

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 officialMENDIRATTA, ANJU (PHYSICIAN / SOLE MBR)