This provider's $3.7M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 12659% from 2019 to 2023.
97% of their billing comes from a single procedure code (Q4217 — Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 30932% in 2023
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 |
|---|---|---|---|---|---|---|---|
| 2019 | $529.47 | $55.63 | 9.52x | $473.84 | $28.8K | 518 | 5 |
| 2020 | $616.48 | $53.46 | 11.53x | $563.02 | $17.4K | 325 | 6 |
| 2021 | $295.36 | $44.87 | 6.58x | $250.49 | $14.9K | 333 | 8 |
| 2022 | $300.26 | $52.42 | 5.73x | $247.84 | $11.8K | 226 | 6 |
| 2023 | $1.3K | $1.0K | 1.30x | $303.22 | $3.7M | 3.6K | 5 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4217 | Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter | 3.3K | $3.6M | $1.1K | 1.28x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 472 | $19.9K | $42.08 | 2.02x |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 200 | $12.4K | $62.03 | 6.36x |
| 99284 | Emergency department visit, problem of high severity | 117 | $8.8K | $75.14 | 21.20x |
| 99285 | Emergency department visit, problem with significant threat to life or function | 67 | $7.6K | $113.66 | 20.89x |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 46 | $6.9K | $149.45 | 2.94x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 81 | $6.6K | $81.05 | 2.07x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 126 | $6.3K | $50.34 | 6.08x |
| 15271 | Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less | 66 | $6.3K | $95.58 | 5.08x |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 110 | $5.6K | $51.22 | 8.05x |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 119 | $5.5K | $46.03 | 2.50x |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 68 | $5.2K | $76.60 | 2.82x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 86 | $5.0K | $58.41 | 2.14x |
| 99283 | Emergency department visit, moderately severe problem | 58 | $2.4K | $42.04 | 25.40x |
| 87502 | Detection test by nucleic acid for multiple types influenza virus | 13 | $1.2K | $95.36 | 1.70x |
| 99344 | Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes | 11 | $1.1K | $95.83 | 2.50x |
| 87651 | Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique | 12 | $418.28 | $34.86 | 2.34x |
| 73560 | X-ray of knee, 1-2 views | 26 | $415.61 | $15.99 | 9.75x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 13 | $267.48 | $20.58 | 7.29x |
| 73630 | X-ray of foot, minimum of 3 views | 14 | $241.92 | $17.28 | 9.46x |
This provider submits charges 1.44 times higher than what Medicare actually pays.
A markup ratio of 1.44x means for every $100 Medicare pays, this provider initially charges $144. This is lower 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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