This provider's $10.6M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 7341% from 2021 to 2023.
96% of their billing comes from a single procedure code (Q4262 — Dual layer impax membrane, per square centimeter).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 6870% 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 | $173.40 | $75.92 | 2.28x | $97.48 | $138.6K | 1.8K | 10 |
| 2022 | $167.15 | $69.44 | 2.41x | $97.71 | $147.9K | 2.1K | 10 |
| 2023 | $928.68 | $713.16 | 1.30x | $215.52 | $10.3M | 14.5K | 9 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4262 | Dual layer impax membrane, per square centimeter | 13.0K | $10.2M | $785.08 | 1.29x |
| 99497 | Advance care planning, first 30 minutes | 1.8K | $99.0K | $53.84 | 2.42x |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 667 | $78.4K | $117.56 | 2.33x |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 800 | $73.7K | $92.09 | 2.28x |
| 99498 | Advance care planning, each additional 30 minutes | 1.2K | $60.1K | $49.15 | 2.33x |
| 99337 | Established patient custodial care facility, group care, or assisted living visit, typically 1 hour | 304 | $39.3K | $129.20 | 2.31x |
| 99358 | Extended patient service without direct patient contact, first hour | 246 | $18.5K | $75.29 | 2.27x |
| 99345 | Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes | 49 | $6.4K | $130.86 | 2.58x |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 57 | $6.1K | $106.62 | 2.41x |
| 99359 | Extended patient service without direct patient contact, each additional 30 minutes | 136 | $4.9K | $36.39 | 2.28x |
| 99328 | New patient assisted living visit, typically 75 minutes | 21 | $2.8K | $135.16 | 2.49x |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 20 | $1.8K | $89.82 | 2.25x |
| G0318 | Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualif | 38 | $796.48 | $20.96 | 2.15x |
| G0317 | Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualifi | 16 | $327.84 | $20.49 | 2.20x |
This provider submits charges 1.33 times higher than what Medicare actually pays.
A markup ratio of 1.33x means for every $100 Medicare pays, this provider initially charges $133. 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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