Physician

Rafael O Duchesne, M.D.

According to 2025 Medicare claims, Rafael Duchesne, M.D. (NPI: 1588657332) practices nephrology in the Dalton, GA market, with the plurality of this provider's patient population coming from Whitfield, GA. This provider's primary affiliated billing organization is NEPHROLOGY & HYPERTENSION SPECIALISTS PC (NPI: 1720295561; TIN: 581597233) and primary practice location at 30720-2506.

Duchesne's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 485 traditional Medicare patients, billed 4,264 HCPCS/CPT codes, and received $212,671 in Medicare payments. The top billing code was 99214 (Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more). Part D data shows 3,615 prescription claims across 507 beneficiaries totaling $805,849 in drug costs, led by Xphozah (Tenapanor Hcl). DME data shows 158 claims. Open Payments data shows 72 records totaling $1,549. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has declined steadily, from $397,958 to $212,671. Concurrently, Part D prescription costs have moved up and down with repeated peaks and valleys, starting at $610,944 and ending at $805,849. In contrast, DME billing represents a smaller volume and moved from a higher plateau to a lower plateau, from $2,552 to $943.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	865	12,257	$397,958
2016	918	13,486	$461,672
2017	993	12,528	$462,246
2018	945	12,017	$420,216
2019	886	11,779	$379,268
2020	688	7,337	$270,881
2021	739	7,520	$324,567
2022	705	7,693	$292,817
2023	753	8,052	$310,472
2024	485	4,264	$212,671

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	529	6,773	$610,944
2016	557	7,629	$1,037,999
2017	538	6,878	$1,304,078
2018	461	4,946	$861,241
2019	424	3,890	$782,613
2020	423	3,973	$881,614
2021	384	3,326	$792,057
2022	369	2,835	$736,574
2023	460	3,457	$1,071,575
2024	507	3,615	$805,849

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	12	227	$8,376
2016	12	167	$4,790
2017	11	177	$4,220
2018	N/R	127	$4,099
2019	N/R	75	$2,011
2020	N/R	49	$2,014
2021	N/R	N/R	N/R
2022	N/R	68	$2,645
2023	N/R	125	$1,846
2024	N/R	158	$3,664

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	227	325	$84
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	193	263	$12
85025	Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	206	286	$8
36415	Insertion of needle into vein for collection of blood sample	244	430	$7
81003	Automated urinalysis test	242	358	$2

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Xphozah	Tenapanor Hcl	63	2,670	$260,104
Rayaldee	Calcifediol	46	1,560	$75,970
Farxiga	Dapagliflozin Propanediol	88	3,720	$70,177
Auryxia	Ferric Citrate	32	1,084	$63,316
Velphoro	Sucroferric Oxyhydroxide	13	552	$54,695

Top 5 DME services in 2024

By Total Medicare Payment Amount.

HCPCS Code	HCPCS Description	Supplier Rental Indicator	Total Supplier Beneficiaries	Total Supplier Claims	Total Medicare Payment Amount
J7518	Mycophenolic acid, oral, 180 mg	N	N/R	11	$1,003
Q0512	Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period	N	N/R	44	$765
J7502	Cyclosporine, oral, 100 mg	N	N/R	11	$591
Q0511	Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period	N	N/R	29	$546
J7507	Tacrolimus, immediate release, oral, 1 mg	N	N/R	19	$396

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	72	$1,549	Otsuka America Pharmaceutical, Inc.
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

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FAQ

What Medicare data is available for Rafael O. Duchesne, M.D.?

Tedicare shows public-source Medicare data for Rafael O. Duchesne, M.D. (NPI 1588657332), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Rafael O. Duchesne, M.D. have ACO affiliation data?

No ACO affiliation record is shown in the available Tedicare data for this profile.

What billing organization is linked to Rafael O. Duchesne, M.D.?

Rafael O. Duchesne, M.D. is linked to NEPHROLOGY & HYPERTENSION SPECIALISTS PC (billing NPI 1720295561) in the available physician profile data.

Does Rafael O. Duchesne, M.D. have Open Payments data?

Rafael O. Duchesne, M.D. has 72 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.