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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Providers
  3. Ileana Helms
⚕️
MDIndividual

Ileana Helms, MD

NPI: 1225039142
Concord, CA
10 years of data
Nephrology
$3.9M
Total Payments
6.2K
Beneficiaries
21.5K
Services
3.37x
Markup Ratio

Peer Comparison

98th
percentile in specialty
This provider$3.9M
Specialty median$185.2K

📋 Key Findings

1Billed $3.9M over 10 years
23.37x markup ratio (above median)
398th percentile in Nephrology by payments
412 procedures with >3x markup
✓ No flags detected

🔎 Data Analysis

This provider's $3.9M in total Medicare payments ranks in the 98th percentile of Nephrology providers nationally.

Medicare payments to this provider grew 77% from 2014 to 2023.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$246.83$128.091.93x$118.74$253.5K1.6K556
2015$368.66$144.122.56x$224.54$331.4K2.0K699
2016$558.97$142.473.92x$416.50$372.1K2.4K671
2017$576.70$151.343.81x$425.36$378.5K2.3K673
2018$599.44$159.933.75x$439.51$418.1K2.4K608
2019$556.86$150.373.70x$406.49$421.0K2.3K567
2020$625.87$181.213.45x$444.66$413.5K2.1K577
2021$632.83$186.723.39x$446.11$429.0K2.0K580
2022$674.55$189.823.55x$484.73$448.3K2.2K618
2023$665.13$186.183.57x$478.95$447.4K2.2K681

Top Procedures (17)

90960Dialysis services (4 or more physician visits per month), patient 20 years of age and older⚠ 3.3x markup
$2.0M
7.6K services$268.40/svc3.30x markup
90961Dialysis services (2-3 physician visits per month), patient 20 years of age and older⚠ 3.3x markup
$572.9K
2.4K services$235.09/svc3.31x markup
99233Subsequent hospital inpatient care, typically 35 minutes per day⚠ 3.5x markup
$497.5K
5.3K services$93.18/svc3.45x markup
99215Established patient office or other outpatient, visit typically 40 minutes⚠ 4.0x markup
$201.0K
1.6K services$123.93/svc4.05x markup
99223Initial hospital inpatient care, typically 70 minutes per day⚠ 3.6x markup
$142.6K
821 services$173.65/svc3.61x markup
99214Established patient office or other outpatient, visit typically 25 minutes⚠ 3.2x markup
$101.5K
1.0K services$100.44/svc3.21x markup
99291Critical care delivery critically ill or injured patient, first 30-74 minutes⚠ 3.6x markup
$90.5K
470 services$192.59/svc3.59x markup
90966Home dialysis services per month, patient 20 years of age or older⚠ 3.2x markup
$78.5K
316 services$248.40/svc3.22x markup
90962Dialysis services (1 physician visit per month), patient 20 years of age and older⚠ 3.5x markup
$61.0K
343 services$177.80/svc3.49x markup
99443Physician telephone patient service, 21-30 minutes of medical discussion⚠ 3.5x markup
$50.9K
472 services$107.90/svc3.47x markup
99232Subsequent hospital inpatient care, typically 25 minutes per day
$23.8K
385 services$61.84/svc2.80x markup
90935Hemodialysis procedure with one physician evaluation
$16.5K
265 services$62.20/svc2.76x markup
99205New patient office or other outpatient visit, typically 60 minutes⚠ 3.9x markup
$16.1K
87 services$184.60/svc3.88x markup
99213Established patient office or other outpatient visit, typically 15 minutes
$12.5K
210 services$59.33/svc1.86x markup
99204New patient office or other outpatient visit, typically 45 minutes
$8.5K
57 services$149.74/svc2.84x markup
99222Initial hospital inpatient care, typically 50 minutes per day
$6.5K
55 services$117.71/svc1.72x markup
90970Dialysis services, per day (less than full month service), patient 20 years of age or older⚠ 3.6x markup
$612.32
86 services$7.12/svc3.65x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
90960Dialysis services (4 or more physician visits per month), patient 20 years of age and older7.6K$2.0M$268.403.30x
90961Dialysis services (2-3 physician visits per month), patient 20 years of age and older2.4K$572.9K$235.093.31x
99233Subsequent hospital inpatient care, typically 35 minutes per day5.3K$497.5K$93.183.45x
99215Established patient office or other outpatient, visit typically 40 minutes1.6K$201.0K$123.934.05x
99223Initial hospital inpatient care, typically 70 minutes per day821$142.6K$173.653.61x
99214Established patient office or other outpatient, visit typically 25 minutes1.0K$101.5K$100.443.21x
99291Critical care delivery critically ill or injured patient, first 30-74 minutes470$90.5K$192.593.59x
90966Home dialysis services per month, patient 20 years of age or older316$78.5K$248.403.22x
90962Dialysis services (1 physician visit per month), patient 20 years of age and older343$61.0K$177.803.49x
99443Physician telephone patient service, 21-30 minutes of medical discussion472$50.9K$107.903.47x
99232Subsequent hospital inpatient care, typically 25 minutes per day385$23.8K$61.842.80x
90935Hemodialysis procedure with one physician evaluation265$16.5K$62.202.76x
99205New patient office or other outpatient visit, typically 60 minutes87$16.1K$184.603.88x
99213Established patient office or other outpatient visit, typically 15 minutes210$12.5K$59.331.86x
99204New patient office or other outpatient visit, typically 45 minutes57$8.5K$149.742.84x
99222Initial hospital inpatient care, typically 50 minutes per day55$6.5K$117.711.72x
90970Dialysis services, per day (less than full month service), patient 20 years of age or older86$612.32$7.123.65x

Markup Analysis

Charge-to-Payment Ratio

3.37x

This provider submits charges 3.37 times higher than what Medicare actually pays.

What This Means

A markup ratio of 3.37x means for every $100 Medicare pays, this provider initially charges $337. This is higher than the national average.

Location

Concord, CA

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

Similar Providers

Other Nephrology providers in CA for peer comparison.

Ileana Helms (you)
$3.9M
Feliciano Serrano, M.D.
$45.3M
Show detailed table ▾
ProviderLocationTotal PaymentsStatus
Feliciano Serrano, M.D.Huntington Park, CA$45.3M✓ Clear

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

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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