This provider's $3.3M in total Medicare payments ranks in the 97th percentile of Nephrology providers nationally.
Medicare payments to this provider grew 156% from 2015 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 95% in 2016
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 |
|---|---|---|---|---|---|---|---|
| 2015 | $309.12 | $119.06 | 2.60x | $190.06 | $197.3K | 1.9K | 1.2K |
| 2016 | $295.39 | $122.57 | 2.41x | $172.82 | $385.7K | 3.8K | 2.1K |
| 2017 | $279.06 | $114.76 | 2.43x | $164.30 | $427.3K | 3.8K | 2.3K |
| 2018 | $286.46 | $105.72 | 2.71x | $180.74 | $380.2K | 3.5K | 1.9K |
| 2019 | $294.67 | $123.27 | 2.39x | $171.40 | $352.7K | 3.5K | 2.0K |
| 2020 | $296.58 | $122.49 | 2.42x | $174.09 | $361.4K | 3.5K | 2.0K |
| 2021 | $305.56 | $139.73 | 2.19x | $165.83 | $363.2K | 3.4K | 1.9K |
| 2022 | $314.80 | $143.42 | 2.19x | $171.38 | $313.5K | 2.7K | 1.6K |
| 2023 | $541.09 | $224.69 | 2.41x | $316.40 | $504.5K | 3.4K | 1.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 3.7K | $924.9K | $252.83 | 2.44x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 7.8K | $473.7K | $60.66 | 2.51x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 3.5K | $319.0K | $90.04 | 2.41x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.5K | $244.7K | $165.58 | 2.56x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.5K | $238.4K | $95.19 | 2.43x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 1.7K | $196.1K | $114.23 | 2.53x |
| 90935 | Hemodialysis procedure with one physician evaluation | 3.1K | $186.5K | $60.70 | 2.78x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.3K | $142.5K | $62.30 | 2.52x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 591 | $125.8K | $212.86 | 2.41x |
| 90966 | Home dialysis services per month, patient 20 years of age or older | 562 | $117.3K | $208.72 | 2.45x |
| J2507 | Injection, pegloticase, 1 mg | 52 | $114.3K | $2.2K | 2.55x |
| 90937 | Hemodialysis procedure with repeated evaluations | 809 | $69.6K | $86.06 | 2.78x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 251 | $33.7K | $134.23 | 2.65x |
| 90945 | Dialysis procedure including one evaluation | 406 | $29.1K | $71.58 | 2.98x |
| 99495 | Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge | 136 | $21.2K | $155.64 | 1.60x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 98 | $20.5K | $209.52 | 1.45x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 91 | $7.8K | $85.42 | 3.11x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 52 | $6.0K | $115.05 | 2.55x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 43 | $3.8K | $87.87 | 2.67x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 26 | $3.6K | $138.96 | 2.23x |
This provider submits charges 2.49 times higher than what Medicare actually pays.
A markup ratio of 2.49x means for every $100 Medicare pays, this provider initially charges $249. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Nephrology providers in NY for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Armistead Williams, M.D. | New York, NY | $37.6M | ✓ Clear |
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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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