This provider's $6.9M in total Medicare payments ranks in the 99th 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 57% 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 | $186.28 | $83.60 | 2.23x | $102.68 | $476.4K | 5.2K | 1.9K |
| 2015 | $174.95 | $75.88 | 2.31x | $99.07 | $746.1K | 7.8K | 2.6K |
| 2016 | $188.17 | $80.16 | 2.35x | $108.01 | $791.0K | 8.4K | 3.0K |
| 2017 | $223.43 | $80.71 | 2.77x | $142.72 | $857.7K | 11.2K | 4.2K |
| 2018 | $195.17 | $75.49 | 2.59x | $119.68 | $837.4K | 11.9K | 4.9K |
| 2019 | $213.28 | $77.30 | 2.76x | $135.98 | $756.2K | 10.8K | 4.4K |
| 2020 | $151.29 | $56.33 | 2.69x | $94.96 | $685.9K | 8.6K | 3.6K |
| 2021 | $170.30 | $76.11 | 2.24x | $94.19 | $737.4K | 11.1K | 5.0K |
| 2022 | $151.54 | $71.94 | 2.11x | $79.60 | $528.1K | 8.7K | 3.7K |
| 2023 | $150.08 | $69.83 | 2.15x | $80.25 | $442.8K | 7.2K | 3.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 10.8K | $2.4M | $222.60 | 2.25x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 7.1K | $1.0M | $146.18 | 2.20x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 18.7K | $1.0M | $53.79 | 2.78x |
| 90966 | Home dialysis services per month, patient 20 years of age or older | 2.9K | $526.2K | $184.30 | 2.71x |
| 90935 | Hemodialysis procedure with one physician evaluation | 9.0K | $485.3K | $54.19 | 5.52x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 3.9K | $379.5K | $98.30 | 1.68x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 1.3K | $233.7K | $182.00 | 2.20x |
| 90945 | Dialysis procedure including one evaluation | 2.5K | $157.1K | $63.73 | 4.71x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.8K | $135.9K | $74.76 | 1.47x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.3K | $114.7K | $49.55 | 1.61x |
| 83970 | Parathormone (parathyroid hormone) level | 1.6K | $63.6K | $40.94 | 2.37x |
| 82306 | Vitamin d-3 level | 1.5K | $42.8K | $29.37 | 2.32x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 393 | $37.2K | $94.64 | 2.55x |
| 80047 | Blood test, basic group of blood chemicals | 2.5K | $31.5K | $12.41 | 4.03x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 276 | $24.9K | $90.07 | 1.39x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 165 | $22.7K | $137.54 | 2.73x |
| 82570 | Creatinine level to test for kidney function or muscle injury | 3.8K | $22.6K | $5.91 | 3.28x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 266 | $18.6K | $70.00 | 1.43x |
| 36415 | Insertion of needle into vein for collection of blood sample | 5.5K | $17.8K | $3.21 | 2.18x |
| 99202 | New patient office or other outpatient visit, typically 20 minutes | 341 | $16.3K | $47.66 | 1.68x |
This provider submits charges 2.61 times higher than what Medicare actually pays.
A markup ratio of 2.61x means for every $100 Medicare pays, this provider initially charges $261. 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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