This provider's $23.4M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 90553% from 2021 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 13855% 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 |
|---|---|---|---|---|---|---|---|
| 2021 | $187.15 | $86.74 | 2.16x | $100.41 | $25.6K | 295 | 7 |
| 2022 | $133.66 | $65.83 | 2.03x | $67.83 | $166.2K | 2.5K | 16 |
| 2023 | $1.4K | $994.48 | 1.44x | $432.87 | $23.2M | 23.3K | 10 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4217 | Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter | 9.7K | $10.7M | $1.1K | 1.43x |
| Q4277 | Woundplus membrane or e-graft, per square centimeter | 5.6K | $7.8M | $1.4K | 1.44x |
| Q4205 | Membrane graft or membrane wrap, per square centimeter | 3.4K | $3.8M | $1.1K | 1.35x |
| Q4188 | Amnioarmor, per square centimeter | 966 | $736.5K | $762.42 | 1.70x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 1.7K | $137.4K | $82.44 | 2.44x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 793 | $50.5K | $63.63 | 2.49x |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 1.3K | $45.9K | $35.87 | 1.45x |
| 99484 | Care management services for behavioral health conditions, 20 minutes or more clinical staff time directed by health care professional | 1.3K | $34.8K | $27.57 | 1.82x |
| 99344 | Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes | 287 | $29.5K | $102.74 | 2.03x |
| 15273 | Skin substitute graft to wound 100.0 sq cm or more of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less | 161 | $27.9K | $173.16 | 1.30x |
| 99496 | Transitional care management services for problem of high complexity | 153 | $24.0K | $156.84 | 1.28x |
| 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 | 189 | $18.3K | $96.59 | 1.86x |
| 99483 | Assessment of and care planning for patient with impaired thought processing, typically 60 minutes | 69 | $9.3K | $134.69 | 1.48x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 55 | $7.7K | $140.63 | 1.38x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 55 | $6.2K | $113.36 | 1.77x |
| 99350 | Established patient home visit, typically 1 hour | 49 | $6.0K | $121.56 | 1.80x |
| 99336 | Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes | 48 | $4.4K | $92.56 | 2.16x |
| 99345 | New patient home visit, typically 75 minutes | 26 | $3.9K | $151.36 | 1.32x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 65 | $2.8K | $43.48 | 2.80x |
| G0180 | Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and | 53 | $1.8K | $33.53 | 3.35x |
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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