This provider's $5.0M in total Medicare payments ranks in the 98th percentile of Nephrology providers nationally.
Medicare payments to this provider grew 483% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 123% in 2015
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 | $209.00 | $78.19 | 2.67x | $130.81 | $113.0K | 1.8K | 757 |
| 2015 | $264.98 | $92.14 | 2.88x | $172.84 | $252.0K | 2.9K | 1.1K |
| 2016 | $282.87 | $92.51 | 3.06x | $190.36 | $379.3K | 3.9K | 1.5K |
| 2017 | $285.21 | $95.08 | 3.00x | $190.13 | $482.0K | 4.5K | 1.5K |
| 2018 | $288.07 | $95.84 | 3.01x | $192.23 | $483.0K | 4.2K | 1.3K |
| 2019 | $335.30 | $111.56 | 3.01x | $223.74 | $581.9K | 5.2K | 1.5K |
| 2020 | $293.19 | $95.12 | 3.08x | $198.07 | $665.1K | 5.9K | 1.8K |
| 2021 | $289.87 | $110.55 | 2.62x | $179.32 | $714.0K | 6.0K | 2.0K |
| 2022 | $296.64 | $111.60 | 2.66x | $185.04 | $717.8K | 6.3K | 1.9K |
| 2023 | $313.50 | $120.76 | 2.60x | $192.74 | $659.1K | 5.7K | 1.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 8.6K | $2.1M | $241.09 | 2.86x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 11.1K | $930.9K | $84.02 | 2.50x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 15.0K | $852.1K | $56.72 | 2.73x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 2.1K | $413.7K | $197.01 | 3.25x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.3K | $198.4K | $154.85 | 1.87x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 1.2K | $124.0K | $103.66 | 1.93x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.4K | $118.9K | $82.82 | 2.72x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 834 | $97.5K | $116.93 | 2.87x |
| 90935 | Hemodialysis procedure with one physician evaluation | 1.5K | $83.5K | $56.68 | 3.44x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.2K | $58.1K | $50.19 | 2.79x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 551 | $43.2K | $78.48 | 3.19x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 184 | $27.0K | $146.59 | 4.02x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 427 | $12.8K | $29.99 | 3.00x |
| 90970 | Dialysis services, per day (less than full month service), patient 20 years of age or older | 904 | $5.7K | $6.26 | 3.67x |
This provider submits charges 2.76 times higher than what Medicare actually pays.
A markup ratio of 2.76x means for every $100 Medicare pays, this provider initially charges $276. 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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