Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Tennessee for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Tennessee only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Tennessee (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Nephrology Associates, PC (NPI 1700878360)

Nephrology Associates, PC is a nephrology physician provider located in Nashville, Tennessee. This profile covers 0 Medicare and 34 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Nephrology Associates, PC
Address	408 42nd Ave N
City	Nashville
State	TN
ZIP	37209
Taxonomy	Nephrology Physician
NPI Enumerated	August 19, 2005

Payer Source	Total Paid
Medicaid	$3.4M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

34 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	31,690	$40	$1.2M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	63,370	$10	$823.8K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	24,820	$20	$521.3K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	19,680	$20	$354.1K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	5,800	$40	$214.5K
90935	Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally…	7,370	$10	$103.2K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	1,950	$20	$43K
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	4,250	$10	$34K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	2,690	$10	$24.2K
90937	Hemodialysis is a procedure that involves drawing blood via an intraarterial or intravenous catheter, then sieving it through a semipermeable membrane to remove the impurities and finally transfusing…	840	$30	$21.1K

Showing 1–10 of 34

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Tennessee providers billing the same CPT/HCPCS codes.

Claims Volume vs. Tennessee Distribution

Nephrology Associates, PC — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

34 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	160	3,760	610	$40	$202.3K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	991	4,050	620	$30	$183.9K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	1	60	1,020	$30	$97.2K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	658	1,080	120	$80	$90.7K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	11	550	290	$30	$77K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	7	840	440	$20	$73K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	189	660	190	$60	$53.3K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	16	480	160	$50	$46.3K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	101	260	280	$20	$35.4K
76770	A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e.Kidneys, urinary bladder, and aorta). This particular code is used when the ultrasound is…	62	80	240	$40	$34.6K

Showing 1–10 of 34

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Oral Facial Surgery Center, LLC	TN	Ambulatory Surgical Clinic/Center	$202.4K	$5.8M
Tnmo Healthcare, LLC	TN	Community Based Hospice Care Agency	$0	$5.7M
Tennessee Orthopaedic Alliance PA	TN	Orthopaedic Surgery Physician	$0	$5.6M
Urology Surgery Center LP	TN	Ambulatory Surgical Clinic/Center	$2.9M	$0
Gautam Jayram	TN	Urology Physician	$340.5K	$0
Marcy Abel	TN	Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician	$311.6K	$0
Edward Mackey	TN	Orthopaedic Surgery Physician	$291.4K	$0
Philip Karpos	TN	Orthopaedic Surgery Physician	$251.4K	$0
Jane Siegel	TN	Orthopaedic Hand Surgery Physician	$240.5K	$0
William Carpenter	TN	Adult Reconstructive Orthopaedic Surgery Physician	$218.1K	$0

Nephrology Associates, PC — Billing Profile & Reimbursement Data

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Nephrology Associates, PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Covenant Family Practice, PC	TN	Family Medicine Physician	$0	$4.8M
Vinai Kumar Katragadda	TN	Nephrology Physician	$360.9K	$0
Ling Yu	TN	Nephrology Physician	$280.3K	$0
Oladapo Omitowoju	TN	Nephrology Physician	$237.4K	$0
Christie Green	TN	Nephrology Physician	$237K	$0
Jyotheen Karam	TN	Nephrology Physician	$218.9K	$0
James Wilbeck	TN	Nephrology Physician	$214.6K	$0
Hany Rezk	TN	Nephrology Physician	$214K	$0
Imran Dosani	GA	Nephrology Physician	$211K	$0
Abhijay Jalota	KY	Nephrology Physician	$201.2K	$0