This provider's $7.8M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 785% from 2021 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 650% 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 |
|---|---|---|---|---|---|---|---|
| 2021 | $413.87 | $298.19 | 1.39x | $115.68 | $452.3K | 1.5K | 6 |
| 2022 | $535.94 | $393.02 | 1.36x | $142.92 | $3.4M | 8.6K | 12 |
| 2023 | $864.51 | $569.78 | 1.52x | $294.73 | $4.0M | 7.0K | 14 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4253 | Zenith amniotic membrane, per square centimeter | 3.8K | $2.8M | $744.80 | 1.28x |
| Q4173 | Palingen or palingen xplus, per square centimeter | 4.7K | $2.3M | $486.35 | 1.45x |
| Q4262 | Dual layer impax membrane, per square centimeter | 1.5K | $1.4M | $916.21 | 1.47x |
| Q4178 | Floweramniopatch, per square centimeter | 2.4K | $855.9K | $355.14 | 1.27x |
| 97610 | Therapy procedure using ultrasound | 524 | $158.3K | $302.07 | 2.52x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 994 | $86.1K | $86.59 | 1.67x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 570 | $69.3K | $121.63 | 1.64x |
| 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 | 615 | $65.7K | $106.78 | 3.28x |
| 11000 | Removal of inflamed or infected skin, up to 10% of body surface | 1.3K | $35.0K | $27.44 | 4.76x |
| 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 | 287 | $31.4K | $109.41 | 3.29x |
| 15004 | Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less | 70 | $18.8K | $267.88 | 1.79x |
| 15002 | Preparation of skin graft site of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less | 58 | $13.6K | $235.17 | 1.79x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 117 | $12.5K | $106.64 | 3.56x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 59 | $7.8K | $132.51 | 2.87x |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 88 | $7.7K | $87.44 | 4.07x |
| 11001 | Removal of inflamed or infected skin, each additional 10% of body surface or less | 127 | $2.3K | $18.36 | 5.17x |
This provider submits charges 1.44 times higher than what Medicare actually pays.
A markup ratio of 1.44x means for every $100 Medicare pays, this provider initially charges $144. 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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