This provider's $4.8M in total Medicare payments ranks in the 98th percentile of Nephrology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $217.43 | $69.73 | 3.12x | $147.70 | $680.8K | 16.5K | 4.0K |
| 2015 | $196.21 | $61.65 | 3.18x | $134.56 | $637.7K | 14.7K | 3.9K |
| 2016 | $185.17 | $55.50 | 3.34x | $129.67 | $568.6K | 13.6K | 3.7K |
| 2017 | $198.33 | $59.61 | 3.33x | $138.72 | $475.3K | 11.6K | 3.4K |
| 2018 | $199.50 | $61.33 | 3.25x | $138.17 | $471.6K | 10.5K | 3.1K |
| 2019 | $190.72 | $59.96 | 3.18x | $130.76 | $483.1K | 10.5K | 3.2K |
| 2020 | $175.79 | $54.53 | 3.22x | $121.26 | $431.9K | 10.4K | 3.4K |
| 2021 | $216.61 | $69.39 | 3.12x | $147.22 | $482.4K | 8.7K | 2.7K |
| 2022 | $208.61 | $64.24 | 3.25x | $144.37 | $330.2K | 6.3K | 2.1K |
| 2023 | $186.05 | $57.40 | 3.24x | $128.65 | $279.3K | 5.3K | 1.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 35.8K | $1.9M | $52.93 | 3.40x |
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 5.1K | $1.2M | $233.14 | 3.06x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 10.5K | $585.4K | $55.56 | 3.03x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 15.3K | $236.7K | $15.46 | 3.30x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.5K | $214.3K | $147.38 | 3.17x |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | 12.4K | $109.7K | $8.83 | 1.94x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 561 | $105.8K | $188.58 | 3.03x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 3.1K | $97.8K | $31.55 | 3.22x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.1K | $82.6K | $72.60 | 3.52x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 642 | $64.1K | $99.80 | 3.17x |
| 76770 | Ultrasound behind abdominal cavity | 1.0K | $58.5K | $56.47 | 3.67x |
| 90966 | Home dialysis services per month, patient 20 years of age or older | 299 | $57.3K | $191.72 | 3.02x |
| 85018 | Hemoglobin measurement | 12.2K | $34.8K | $2.86 | 6.25x |
| J0897 | Injection, denosumab, 1 mg | 2.2K | $32.2K | $14.77 | 1.96x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 160 | $22.3K | $139.30 | 3.05x |
| 99406 | Smoking and tobacco use intermediate counseling, greater than 3 minutes up to 10 minutes | 885 | $11.7K | $13.21 | 2.57x |
| 81002 | Urinalysis, manual test | 2.5K | $8.5K | $3.41 | 2.93x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 132 | $7.8K | $59.02 | 4.33x |
| 99441 | Physician telephone patient service, 5-10 minutes of medical discussion | 246 | $7.2K | $29.45 | 1.58x |
| 82570 | Creatinine level to test for kidney function or muscle injury | 949 | $5.8K | $6.10 | 3.25x |
This provider submits charges 3.21 times higher than what Medicare actually pays.
A markup ratio of 3.21x means for every $100 Medicare pays, this provider initially charges $321. This is higher than the national average.
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Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.
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