This provider's $3.5M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 2274% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 798% 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 | $138.88 | $52.67 | 2.64x | $86.21 | $24.1K | 368 | 212 |
| 2015 | $93.27 | $49.28 | 1.89x | $43.99 | $216.8K | 3.3K | 702 |
| 2016 | $82.11 | $42.79 | 1.92x | $39.32 | $238.3K | 4.1K | 1.4K |
| 2017 | $86.69 | $39.43 | 2.20x | $47.26 | $231.8K | 4.1K | 1.4K |
| 2018 | $77.99 | $38.11 | 2.05x | $39.88 | $260.7K | 4.4K | 1.8K |
| 2019 | $71.41 | $37.04 | 1.93x | $34.37 | $413.5K | 6.5K | 2.1K |
| 2020 | $83.30 | $47.16 | 1.77x | $36.14 | $596.9K | 7.0K | 2.1K |
| 2021 | $82.62 | $46.39 | 1.78x | $36.23 | $485.0K | 5.9K | 1.7K |
| 2022 | $104.19 | $55.66 | 1.87x | $48.53 | $432.9K | 5.5K | 1.2K |
| 2023 | $95.67 | $54.25 | 1.76x | $41.42 | $573.1K | 7.8K | 1.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99336 | Established patient assisted living visit, typically 40 minutes | 14.3K | $1.2M | $85.75 | 1.82x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 6.1K | $775.1K | $126.40 | 1.78x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 5.1K | $416.8K | $81.24 | 1.81x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 6.0K | $351.4K | $58.87 | 1.88x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.8K | $101.8K | $55.41 | 2.27x |
| 99358 | Prolonged patient service without direct patient contact first hour | 1.3K | $89.6K | $70.92 | 1.78x |
| 99487 | Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month | 1.1K | $88.2K | $79.43 | 1.91x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 971 | $76.2K | $78.47 | 2.18x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 1.2K | $64.8K | $54.57 | 1.83x |
| 99489 | Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month | 1.1K | $48.8K | $43.57 | 1.83x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 173 | $17.6K | $101.56 | 1.46x |
| 99327 | New patient assisted living visit, typically 60 minutes | 151 | $16.4K | $108.55 | 1.98x |
| 99326 | New patient assisted living visit, typically 45 minutes | 187 | $14.5K | $77.67 | 2.07x |
| G0008 | Administration of influenza virus vaccine | 669 | $13.7K | $20.51 | 1.44x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 97 | $13.6K | $140.28 | 1.88x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 1.2K | $12.7K | $10.39 | 2.20x |
| 90662 | Vaccine for influenza for injection into muscle | 186 | $12.5K | $67.06 | 1.21x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 867 | $12.2K | $14.03 | 3.06x |
| 99334 | Established patient assisted living visit, typically 15 minutes | 282 | $11.7K | $41.47 | 1.69x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 221 | $11.4K | $51.57 | 2.01x |
This provider submits charges 1.85 times higher than what Medicare actually pays.
A markup ratio of 1.85x means for every $100 Medicare pays, this provider initially charges $185. 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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