This provider's $3.6M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 14313% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 24248% in 2018
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 | $103.83 | $58.37 | 1.78x | $45.46 | $6.4K | 113 | 113 |
| 2015 | $97.09 | $44.35 | 2.19x | $52.74 | $10.2K | 181 | 177 |
| 2016 | $79.00 | $40.93 | 1.93x | $38.07 | $3.3K | 80 | 75 |
| 2017 | $79.00 | $24.03 | 3.29x | $54.97 | $432.48 | 18 | 18 |
| 2018 | $157.33 | $86.59 | 1.82x | $70.74 | $105.3K | 1.2K | 736 |
| 2019 | $168.18 | $89.64 | 1.88x | $78.54 | $234.1K | 2.0K | 758 |
| 2020 | $138.21 | $69.88 | 1.98x | $68.33 | $392.1K | 4.6K | 2.3K |
| 2021 | $132.65 | $75.80 | 1.75x | $56.85 | $776.8K | 10.9K | 3.6K |
| 2022 | $134.17 | $79.30 | 1.69x | $54.87 | $1.1M | 14.1K | 4.6K |
| 2023 | $127.60 | $74.82 | 1.71x | $52.78 | $917.1K | 14.0K | 5.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99350 | Established patient home visit, typically 60 minutes | 7.1K | $854.3K | $120.70 | 2.07x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 4.5K | $590.3K | $131.20 | 1.90x |
| 99354 | Prolonged office or other outpatient service first hour | 4.9K | $430.3K | $88.31 | 1.41x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 6.8K | $274.4K | $40.41 | 1.61x |
| 99487 | Complex chronic care management services 60 minutes clinical staff time | 1.9K | $149.4K | $77.47 | 1.53x |
| 99439 | Chronic care management services, each additional 20 minutes of clinical staff time per calendar month | 4.6K | $139.8K | $30.42 | 1.31x |
| 99345 | New patient home visit, typically 75 minutes | 933 | $124.7K | $133.67 | 2.24x |
| 99483 | Assessment of and care planning for patient with impaired thought processing, typically 50 minutes | 546 | $106.4K | $194.81 | 1.54x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 1.3K | $88.1K | $67.74 | 1.48x |
| G3002 | Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan tha | 1.5K | $83.7K | $54.14 | 1.48x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 359 | $71.8K | $200.07 | 1.50x |
| 99489 | Complex chronic care management services each additional 30 minutes clinical staff time | 1.9K | $71.4K | $38.00 | 1.58x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 589 | $68.6K | $116.41 | 1.03x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 1.4K | $60.6K | $42.55 | 1.76x |
| 99349 | Established patient home visit, typically 40 minutes | 713 | $58.5K | $82.11 | 2.30x |
| 99358 | Prolonged patient service without direct patient contact first hour | 639 | $47.6K | $74.43 | 2.02x |
| 99328 | New patient assisted living visit, typically 75 minutes | 306 | $44.3K | $144.72 | 1.73x |
| 99457 | Remote physiologic monitoring treatment management services, health care professional time in a calendar month requiring interactive communication with the patient/caregiver; first 20 minutes | 1.0K | $36.5K | $35.90 | 2.09x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 394 | $34.2K | $86.84 | 1.94x |
| G0318 | Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualif | 1.6K | $32.7K | $20.72 | 3.86x |
This provider submits charges 1.8 times higher than what Medicare actually pays.
A markup ratio of 1.8x means for every $100 Medicare pays, this provider initially charges $180. 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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