This provider's $8.6M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 15428% from 2019 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1094% 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 |
|---|---|---|---|---|---|---|---|
| 2019 | $140.51 | $68.38 | 2.05x | $72.13 | $47.7K | 698 | 9 |
| 2020 | $131.33 | $64.25 | 2.04x | $67.08 | $142.1K | 2.2K | 16 |
| 2021 | $117.63 | $56.75 | 2.07x | $60.88 | $394.8K | 7.0K | 16 |
| 2022 | $123.55 | $60.15 | 2.05x | $63.40 | $621.0K | 10.3K | 17 |
| 2023 | $1.0K | $608.01 | 1.72x | $436.43 | $7.4M | 12.2K | 18 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4262 | Dual layer impax membrane, per square centimeter | 3.9K | $4.2M | $1.1K | 1.68x |
| Q4276 | Orion, per square centimeter | 2.4K | $2.8M | $1.2K | 1.67x |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 6.8K | $577.8K | $84.82 | 1.73x |
| 11045 | Removal of skin and tissue, each additional 20.0 sq cm or less | 6.6K | $202.8K | $30.51 | 2.87x |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 2.0K | $145.2K | $73.37 | 2.52x |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 777 | $127.9K | $164.65 | 2.10x |
| 99347 | Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes | 2.5K | $91.6K | $36.49 | 2.78x |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 1.4K | $69.6K | $50.16 | 2.03x |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 1.2K | $66.2K | $53.45 | 2.35x |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 746 | $58.1K | $77.91 | 2.00x |
| 99344 | Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes | 417 | $52.0K | $124.70 | 2.30x |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 397 | $48.7K | $122.56 | 1.81x |
| 99334 | Established patient custodial care facility, group care, or assisted living visit, typically 15 minutes | 1.0K | $45.7K | $43.57 | 2.18x |
| 11046 | Removal of muscle and/or tissue, each additional 20.0 sq cm or less | 636 | $35.8K | $56.25 | 1.69x |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 172 | $24.3K | $141.25 | 1.83x |
| 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 | 207 | $22.3K | $107.80 | 2.08x |
| 99349 | Established patient home visit, typically 40 minutes | 229 | $21.1K | $91.99 | 2.44x |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 193 | $19.7K | $101.94 | 2.23x |
| 99348 | Established patient home visit, typically 25 minutes | 272 | $16.4K | $60.17 | 2.48x |
| 99327 | New patient custodial care facility, group care, or assisted living visit, typically 1 hour | 82 | $10.7K | $130.62 | 1.91x |
This provider submits charges 1.77 times higher than what Medicare actually pays.
A markup ratio of 1.77x means for every $100 Medicare pays, this provider initially charges $177. 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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