Physician
Gulf Coast Nephrology, LLC
Gulf Coast Nephrology, LLC was paid $28K by Medicaid between Mar 2023 and Nov 2024, across 10 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 — 36% of everything it billed.
33Billing provider infoGULF COAST NEPHROLOGY, LLC
LAKE CHARLES, LA 70601
LAKE CHARLES, LA 70601
33aNPI1982340774assigned 05/05/2022
33bProvider typeNephrology Physician
28Total paid$28K
24GClaims2,036
24DCodes billed10
24AFirst – last monthMar 2023 – Nov 2024
Compared with peers
Next to other Nephrology Physician providers in Louisiana
Rank by total paid#34 of 56
Median peer was paid$52K
This provider vs. median0.5×
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 | |
|---|---|---|---|
| 2023 | 1,305 | $16K | |
| 2024incomplete | 731 | $12K |
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 | 36% | 658 | 620 | $10K |
| 90935 | Hemodialysis procedure with single evaluation by a physician | 26% | 547 | 96 | $7K |
| 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 | 17% | 318 | 281 | $5K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 9.0% | 165 | 44 | $3K |
| 90961 | 4.3% | 128 | 115 | $1K | |
| 90962 | 2.8% | 19 | 15 | $781.91 | |
| 99222 | Initial hospital care, per day, moderate complexity | 2.0% | 34 | 26 | $571.86 |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.9% | 42 | 39 | $542.01 |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 19 | 12 | $224.55 |
| 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% | 106 | 102 | $9.75 |
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 officialDEL TORO, DIANA (OFFICER OF THE COMPANY)