This provider's $6.3M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 3721% from 2019 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 2449% 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 | $20.41 | $10.33 | 1.98x | $10.08 | $88.7K | 8.6K | 18 |
| 2020 | $170.36 | $65.70 | 2.59x | $104.66 | $33.7K | 513 | 4 |
| 2021 | $180.77 | $71.06 | 2.54x | $109.71 | $107.0K | 1.5K | 4 |
| 2022 | $629.82 | $448.59 | 1.40x | $181.23 | $2.7M | 6.1K | 9 |
| 2023 | $875.04 | $571.19 | 1.53x | $303.85 | $3.4M | 5.9K | 9 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4236 | Carepatch, per square centimeter | 2.9K | $2.8M | $978.62 | 1.41x |
| Q4253 | Zenith amniotic membrane, per square centimeter | 3.9K | $2.6M | $663.73 | 1.30x |
| 97610 | Therapy procedure using ultrasound | 1.5K | $442.7K | $300.33 | 1.50x |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 1.8K | $163.0K | $88.24 | 2.89x |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 2.5K | $132.8K | $54.15 | 3.30x |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 514 | $63.3K | $123.24 | 3.16x |
| 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 | 232 | $24.1K | $103.74 | 4.07x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 299 | $21.7K | $72.50 | 2.05x |
| 99342 | New patient home visit, typically 30 minutes | 305 | $14.5K | $47.39 | 2.85x |
| J7328 | Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg | 6.6K | $12.0K | $1.84 | 1.63x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 106 | $10.2K | $96.32 | 2.08x |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 55 | $8.9K | $161.15 | 2.88x |
| 97597 | Removal of tissue from wound, 20.0 sq cm or less | 127 | $8.6K | $68.11 | 9.91x |
| 11000 | Removal of inflamed or infected skin, up to 10% of body surface | 174 | $4.7K | $27.17 | 3.72x |
| 15275 | Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less | 42 | $4.5K | $107.47 | 3.02x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 52 | $4.5K | $86.54 | 3.82x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 72 | $3.6K | $50.52 | 2.00x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 24 | $3.5K | $146.16 | 1.63x |
| 99345 | New patient home visit, typically 75 minutes | 23 | $3.3K | $144.14 | 2.12x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 23 | $3.0K | $130.50 | 2.19x |
This provider submits charges 1.51 times higher than what Medicare actually pays.
A markup ratio of 1.51x means for every $100 Medicare pays, this provider initially charges $151. 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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