This provider's $16.8M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 72149% from 2019 to 2023.
65% 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 31727% in 2022
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 |
|---|---|---|---|---|---|---|---|
| 2019 | $178.96 | $77.63 | 2.31x | $101.33 | $22.0K | 283 | 4 |
| 2020 | $127.32 | $57.39 | 2.22x | $69.93 | $5.2K | 91 | 3 |
| 2021 | $199.00 | $104.69 | 1.90x | $94.31 | $2.8K | 27 | 1 |
| 2022 | $771.92 | $564.04 | 1.37x | $207.88 | $899.6K | 1.6K | 3 |
| 2023 | $1.2K | $870.59 | 1.34x | $297.14 | $15.9M | 18.2K | 13 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4262 | Dual layer impax membrane, per square centimeter | 11.1K | $10.9M | $977.78 | 1.31x |
| Q4281 | Barrera sl or barrera dl, per square centimeter | 2.2K | $2.5M | $1.2K | 1.33x |
| Q4253 | Zenith amniotic membrane, per square centimeter | 2.9K | $2.1M | $720.11 | 1.32x |
| Q4276 | Orion, per square centimeter | 914 | $995.7K | $1.1K | 1.33x |
| 15271 | Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less | 729 | $91.9K | $126.13 | 3.09x |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 833 | $81.3K | $97.57 | 2.70x |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 590 | $34.6K | $58.58 | 2.56x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 263 | $25.1K | $95.45 | 2.52x |
| 99345 | Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes | 124 | $18.5K | $149.28 | 3.01x |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 127 | $16.0K | $125.72 | 2.65x |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 43 | $8.1K | $187.75 | 3.08x |
| 99342 | Residence visit for new patient with low level of medical decision making, per day, if using time, at least 30 minutes | 90 | $5.2K | $58.06 | 2.40x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 105 | $3.4K | $32.16 | 2.80x |
| 99344 | Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes | 30 | $3.3K | $108.36 | 3.31x |
| 15272 | Application of skin substitute graft to wound of trunk, arms, or legs, each additional 25.0 sq cm of wound 100.0 sq cm or less | 79 | $1.5K | $19.47 | 2.57x |
| 99347 | Established patient home visit, typically 15 minutes | 34 | $1.4K | $40.26 | 2.09x |
| 11000 | Removal of inflamed or infected skin, up to 10% of body surface | 40 | $1.1K | $27.28 | 4.03x |
This provider submits charges 1.34 times higher than what Medicare actually pays.
A markup ratio of 1.34x means for every $100 Medicare pays, this provider initially charges $134. 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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