Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Physician

Durham Nephrology Associates PA

Durham Nephrology Associates PA was paid $707K by Medicaid between Jan 2018 and Nov 2024, across 16 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 — 70% of everything it billed.

33Billing provider infoDURHAM NEPHROLOGY ASSOCIATES PA
DURHAM, NC 27704
33aNPI1962583203assigned 10/17/2006
33bProvider typeNephrology Physician
28Total paid$707K
24GClaims25,606
24DCodes billed16
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers

Next to other Nephrology Physician providers in North Carolina

Rank by total paid#8 of 41
Median peer was paid$168K
This provider vs. median4.2×

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

$0$10K$20K2018201920202021202220232024
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
YearClaimsPaid
20184,473$105K
20194,807$123K
20204,719$142K
20213,752$100K
20223,326$112K
20232,726$70K
2024incomplete1,803$54K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
90960 End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits 70% 13,671 11,636 $494K
99232 Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity 14% 5,910 2,812 $102K
99233 Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m 5.3% 1,075 550 $37K
90935 Hemodialysis procedure with single evaluation by a physician 4.1% 2,888 1,727 $29K
90961 3.0% 741 648 $21K
90937 2.1% 807 495 $15K
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% 184 151 $5K
99490 Ccm add 20min <1% 129 123 $2K
99223 Prolong inpt eval add15 m <1% 28 24 $649.02
99152 <1% 40 25 $322.70
99222 Initial hospital care, per day, moderate complexity <1% 13 12 $319.43
99497 <1% 28 27 $214.50
4 more codes
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% 27 $71.89
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml <1% 21 $33.70
J3010 Injection, fentanyl citrate, 0.1 mg <1% 22 $0.50
J2250 Injection, midazolam hydrochloride, per 1 mg <1% 22 $0.02

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 officialCOOPERBERG, CHARLES (PRESIDENT)