This provider's $3.2M in total Medicare payments ranks in the 97th percentile of Nephrology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
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 |
|---|---|---|---|---|---|---|---|
| 2014 | $256.32 | $91.29 | 2.81x | $165.03 | $330.5K | 3.5K | 1.3K |
| 2015 | $238.38 | $83.07 | 2.87x | $155.31 | $299.2K | 3.1K | 1.2K |
| 2016 | $263.66 | $87.62 | 3.01x | $176.04 | $320.9K | 3.5K | 1.4K |
| 2017 | $259.08 | $87.10 | 2.97x | $171.98 | $348.5K | 3.5K | 1.4K |
| 2018 | $267.07 | $91.95 | 2.90x | $175.12 | $338.3K | 3.2K | 1.3K |
| 2019 | $264.67 | $89.35 | 2.96x | $175.32 | $324.9K | 3.0K | 1.2K |
| 2020 | $277.57 | $101.63 | 2.73x | $175.94 | $314.3K | 2.7K | 1.0K |
| 2021 | $273.69 | $109.62 | 2.50x | $164.07 | $350.6K | 2.5K | 933 |
| 2022 | $291.58 | $116.76 | 2.50x | $174.82 | $301.9K | 2.1K | 853 |
| 2023 | $347.00 | $129.62 | 2.68x | $217.38 | $290.6K | 2.2K | 876 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 6.7K | $1.2M | $187.33 | 2.28x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 8.4K | $604.3K | $71.90 | 3.02x |
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 1.7K | $391.2K | $232.16 | 2.23x |
| 90966 | Home dialysis services per month, patient 20 years of age or older | 1.4K | $254.1K | $182.53 | 1.88x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 3.3K | $182.1K | $54.89 | 2.86x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.5K | $121.1K | $79.40 | 2.82x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 1.1K | $110.7K | $101.94 | 2.87x |
| 90937 | Hemodialysis procedure with repeated evaluations | 1.2K | $92.3K | $79.17 | 5.11x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 718 | $79.2K | $110.31 | 3.07x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 442 | $60.5K | $136.92 | 2.51x |
| 99443 | Physician telephone patient service, 21-30 minutes of medical discussion | 248 | $15.2K | $61.15 | 3.55x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 91 | $13.6K | $148.95 | 2.87x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 866 | $13.1K | $15.15 | 3.04x |
| 90945 | Dialysis procedure including one evaluation | 141 | $9.2K | $65.04 | 3.55x |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | 844 | $7.5K | $8.89 | 3.15x |
| 99238 | Hospital discharge day management, 30 minutes or less | 118 | $6.4K | $53.95 | 3.24x |
| 90935 | Hemodialysis procedure with one physician evaluation | 98 | $5.5K | $55.68 | 6.88x |
| 90947 | Dialysis procedure requiring repeat evaluation | 32 | $3.0K | $92.55 | 5.94x |
| 90970 | Dialysis services, per day (less than full month service), patient 20 years of age or older | 366 | $2.1K | $5.82 | 2.58x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 36 | $1.6K | $44.11 | 3.24x |
This provider submits charges 2.59 times higher than what Medicare actually pays.
A markup ratio of 2.59x means for every $100 Medicare pays, this provider initially charges $259. This is higher 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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