This provider's $5.4M in total Medicare payments ranks in the 98th 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 | $353.75 | $133.54 | 2.65x | $220.21 | $371.0K | 3.9K | 1.3K |
| 2015 | $353.75 | $132.59 | 2.67x | $221.16 | $477.7K | 4.8K | 1.4K |
| 2016 | $342.22 | $132.82 | 2.58x | $209.40 | $472.9K | 4.6K | 1.3K |
| 2017 | $341.13 | $127.49 | 2.68x | $213.64 | $537.2K | 5.1K | 1.5K |
| 2018 | $346.50 | $123.13 | 2.81x | $223.37 | $602.5K | 5.1K | 1.6K |
| 2019 | $341.89 | $133.23 | 2.57x | $208.66 | $749.6K | 5.2K | 1.7K |
| 2020 | $353.75 | $139.98 | 2.53x | $213.77 | $634.1K | 3.6K | 1.1K |
| 2021 | $306.48 | $139.43 | 2.20x | $167.05 | $582.1K | 3.2K | 1.1K |
| 2022 | $319.50 | $141.45 | 2.26x | $178.05 | $441.5K | 3.2K | 1.1K |
| 2023 | $373.89 | $150.57 | 2.48x | $223.32 | $517.7K | 3.8K | 1.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 10.0K | $2.7M | $268.48 | 2.23x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 21.2K | $1.3M | $63.30 | 1.52x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 2.3K | $393.9K | $174.68 | 1.72x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 1.4K | $301.6K | $223.21 | 2.68x |
| 90935 | Hemodialysis procedure with one physician evaluation | 3.2K | $200.1K | $62.86 | 6.34x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.9K | $168.5K | $90.40 | 1.39x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 1.4K | $159.5K | $115.98 | 2.15x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 409 | $67.7K | $165.53 | 3.62x |
| 99238 | Hospital discharge day management, 30 minutes or less | 549 | $35.2K | $64.14 | 1.87x |
| 90966 | Home dialysis services per month (20 years or older) | 56 | $14.6K | $261.23 | 2.30x |
| 99239 | Hospital discharge day management, more than 30 minutes | 126 | $12.4K | $98.22 | 1.78x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 112 | $4.2K | $37.24 | 1.90x |
This provider submits charges 2.18 times higher than what Medicare actually pays.
A markup ratio of 2.18x means for every $100 Medicare pays, this provider initially charges $218. 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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