This provider's $9.3M 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.
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 | $309.33 | $106.32 | 2.91x | $203.01 | $889.5K | 11.8K | 3.0K |
| 2015 | $332.23 | $112.62 | 2.95x | $219.61 | $910.3K | 12.0K | 3.0K |
| 2016 | $327.84 | $105.98 | 3.09x | $221.86 | $961.5K | 13.3K | 3.0K |
| 2017 | $254.13 | $109.55 | 2.32x | $144.58 | $871.3K | 11.5K | 2.6K |
| 2018 | $261.54 | $114.93 | 2.28x | $146.61 | $876.6K | 12.0K | 2.6K |
| 2019 | $266.65 | $121.01 | 2.20x | $145.64 | $856.4K | 11.3K | 2.5K |
| 2020 | $269.64 | $131.59 | 2.05x | $138.05 | $791.1K | 10.1K | 2.5K |
| 2021 | $280.86 | $160.91 | 1.75x | $119.95 | $883.2K | 10.6K | 2.8K |
| 2022 | $379.80 | $163.47 | 2.32x | $216.33 | $1.1M | 13.5K | 3.3K |
| 2023 | $444.64 | $160.12 | 2.78x | $284.52 | $1.1M | 12.5K | 3.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 80.2K | $5.3M | $66.01 | 3.84x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 9.5K | $1.2M | $124.62 | 2.85x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 9.9K | $607.9K | $61.45 | 3.00x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 3.4K | $513.1K | $151.62 | 1.74x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 1.8K | $436.0K | $236.80 | 2.11x |
| 99238 | Hospital discharge day management, 30 minutes or less | 5.5K | $364.8K | $66.46 | 3.68x |
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 915 | $288.8K | $315.58 | 2.34x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 1.5K | $247.8K | $167.43 | 2.95x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.6K | $113.7K | $71.68 | 2.37x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 2.9K | $113.0K | $39.22 | 3.19x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 714 | $65.5K | $91.77 | 3.32x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 217 | $21.3K | $98.35 | 2.33x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 181 | $14.7K | $81.14 | 2.77x |
| 99235 | Hospital observation or inpatient care moderate severity, 50 minutes per day' | 95 | $14.6K | $153.79 | 1.79x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 112 | $12.6K | $112.49 | 1.78x |
| 99236 | Hospital observation or inpatient care high severity, 55 minutes per day | 32 | $6.1K | $191.73 | 2.61x |
| 99316 | Nursing facility discharge management, more than 30 minutes | 60 | $5.8K | $95.92 | 2.50x |
| 99202 | New patient office or other outpatient visit, typically 20 minutes | 43 | $2.7K | $62.32 | 2.06x |
| G0180 | Physician 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 to affirm the initial imple | 11 | $531.30 | $48.30 | 3.11x |
This provider submits charges 3.34 times higher than what Medicare actually pays.
A markup ratio of 3.34x means for every $100 Medicare pays, this provider initially charges $334. 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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