This provider's $4.5M 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.
Notable: Payments increased 60% in 2020
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 |
|---|---|---|---|---|---|---|---|
| 2014 | $325.71 | $125.83 | 2.59x | $199.88 | $514.3K | 5.6K | 1.8K |
| 2015 | $361.83 | $136.39 | 2.65x | $225.44 | $491.4K | 5.7K | 1.7K |
| 2016 | $287.91 | $131.59 | 2.19x | $156.32 | $412.7K | 4.5K | 1.7K |
| 2017 | $228.16 | $104.01 | 2.19x | $124.15 | $272.9K | 3.2K | 1.6K |
| 2018 | $267.82 | $99.67 | 2.69x | $168.15 | $337.9K | 4.1K | 1.7K |
| 2019 | $245.66 | $121.51 | 2.02x | $124.15 | $337.4K | 3.6K | 1.5K |
| 2020 | $226.99 | $114.08 | 1.99x | $112.91 | $540.9K | 6.1K | 1.8K |
| 2021 | $293.90 | $128.02 | 2.30x | $165.88 | $480.9K | 5.1K | 1.8K |
| 2022 | $281.60 | $121.05 | 2.33x | $160.55 | $564.4K | 6.1K | 1.8K |
| 2023 | $293.26 | $126.19 | 2.32x | $167.07 | $566.8K | 5.2K | 1.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 13.0K | $1.2M | $89.28 | 2.39x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 16.8K | $1.0M | $61.25 | 2.32x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 2.3K | $515.1K | $220.77 | 2.09x |
| 90935 | Hemodialysis procedure with one physician evaluation | 6.8K | $416.4K | $61.18 | 2.38x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 2.1K | $346.9K | $168.62 | 2.32x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 3.0K | $341.1K | $115.19 | 2.20x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 1.8K | $279.9K | $156.55 | 2.36x |
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 762 | $196.1K | $257.30 | 2.16x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 576 | $51.8K | $89.95 | 2.40x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 791 | $46.5K | $58.83 | 2.55x |
| 99219 | Hospital observation care, typically 50 minutes | 203 | $23.2K | $114.21 | 2.48x |
| 90966 | Home dialysis services per month, patient 20 years of age or older | 97 | $19.4K | $199.66 | 2.63x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 113 | $13.6K | $120.66 | 2.60x |
| 99239 | Hospital discharge day management, more than 30 minutes | 145 | $13.4K | $92.73 | 2.52x |
| 90945 | Dialysis procedure including one evaluation | 179 | $12.8K | $71.72 | 2.49x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 104 | $11.4K | $109.45 | 2.74x |
| 99238 | Hospital discharge day management, 30 minutes or less | 168 | $10.0K | $59.28 | 2.42x |
| 90937 | Hemodialysis procedure with repeated evaluations | 100 | $9.0K | $90.36 | 2.33x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 38 | $6.5K | $170.38 | 2.69x |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 42 | $3.8K | $89.41 | 2.24x |
This provider submits charges 2.31 times higher than what Medicare actually pays.
A markup ratio of 2.31x means for every $100 Medicare pays, this provider initially charges $231. 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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