⚠️ This provider averages 362 services per working day — physically unusual for an individual practitioner
Based on 362.4K total services over 4 years (250 working days/year). Learn about impossible service volumes →
This provider's $8.3M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Averaging 362 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 17943% from 2020 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 6027% in 2022
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 |
|---|---|---|---|---|---|---|---|
| 2020 | $159.77 | $100.94 | 1.58x | $58.83 | $31.8K | 315 | 5 |
| 2021 | $171.38 | $99.44 | 1.72x | $71.94 | $41.1K | 413 | 6 |
| 2022 | $105.09 | $23.45 | 4.48x | $81.64 | $2.5M | 107.3K | 20 |
| 2023 | $104.25 | $22.55 | 4.62x | $81.70 | $5.7M | 254.4K | 23 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J3380 | Injection, vedolizumab, 1 mg | 82.2K | $1.4M | $16.95 | 4.70x |
| J3245 | Injection, tildrakizumab, 1 mg | 11.1K | $1.2M | $109.22 | 4.42x |
| J0897 | Injection, denosumab, 1 mg | 54.7K | $974.3K | $17.80 | 5.18x |
| J0517 | Injection, benralizumab, 1 mg | 6.2K | $812.9K | $132.17 | 4.11x |
| J2350 | Injection, ocrelizumab, 1 mg | 15.9K | $724.0K | $45.54 | 3.27x |
| J2357 | Injection, omalizumab, 5 mg | 22.4K | $673.3K | $30.02 | 3.29x |
| J3111 | Injection, romosozumab-aqqg, 1 mg | 73.3K | $567.8K | $7.75 | 4.06x |
| J2182 | Injection, mepolizumab, 1 mg | 23.1K | $532.0K | $23.03 | 3.43x |
| J1569 | Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg | 14.6K | $518.7K | $35.62 | 5.37x |
| J1306 | Injection, inclisiran, 1 mg | 30.4K | $285.1K | $9.38 | 6.70x |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 9.2K | $246.7K | $26.82 | 10.45x |
| J2356 | Injection, tezepelumab-ekko, 1 mg | 12.4K | $175.5K | $14.16 | 4.68x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 1.3K | $53.3K | $40.08 | 5.97x |
| 99350 | Established patient home visit, typically 1 hour | 277 | $31.3K | $113.01 | 1.92x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 361 | $28.4K | $78.74 | 3.41x |
| 96372 | Injection of drug or substance under skin or into muscle | 2.3K | $20.8K | $8.98 | 5.72x |
| 99345 | New patient home visit, typically 75 minutes | 130 | $18.8K | $144.25 | 1.84x |
| 99354 | Extended office or other outpatient service, first hour | 209 | $17.7K | $84.66 | 1.28x |
| 96366 | Infusion into a vein for therapy, prevention, or diagnosis, each additional hour | 1.1K | $14.1K | $13.00 | 4.62x |
| 99355 | Prolonged outpatient service, each additional 30 minutes | 102 | $6.6K | $64.46 | 1.33x |
This provider submits charges 4.55 times higher than what Medicare actually pays.
A markup ratio of 4.55x means for every $100 Medicare pays, this provider initially charges $455. 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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