This provider's $3.2M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 627% from 2017 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 249% in 2018
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 |
|---|---|---|---|---|---|---|---|
| 2017 | $297.89 | $125.23 | 2.38x | $172.66 | $70.7K | 567 | 311 |
| 2018 | $229.76 | $97.85 | 2.35x | $131.91 | $246.8K | 2.1K | 760 |
| 2019 | $282.57 | $102.65 | 2.75x | $179.92 | $340.3K | 3.1K | 1.2K |
| 2020 | $137.04 | $78.14 | 1.75x | $58.90 | $759.4K | 8.2K | 3.8K |
| 2021 | $110.06 | $63.73 | 1.73x | $46.33 | $648.0K | 7.2K | 2.8K |
| 2022 | $114.79 | $66.98 | 1.71x | $47.81 | $630.6K | 6.8K | 2.0K |
| 2023 | $116.65 | $65.99 | 1.77x | $50.66 | $513.8K | 5.4K | 1.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99337 | Established patient assisted living visit, typically 60 minutes | 12.5K | $1.5M | $122.78 | 1.84x |
| 99350 | Established patient home visit, typically 60 minutes | 4.6K | $550.5K | $118.61 | 1.70x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 3.1K | $267.8K | $85.90 | 1.86x |
| 87635 | Sars-cov-2 covid-19 amp prb | 2.9K | $146.9K | $51.24 | 1.86x |
| 99349 | Established patient home visit, typically 40 minutes | 1.3K | $101.0K | $79.80 | 1.90x |
| 99328 | New patient assisted living visit, typically 75 minutes | 719 | $96.4K | $134.14 | 1.99x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 309 | $52.3K | $169.12 | 1.58x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 451 | $46.3K | $102.73 | 1.53x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 643 | $36.5K | $56.70 | 2.05x |
| 99345 | New patient home visit, typically 75 minutes | 264 | $36.0K | $136.26 | 2.04x |
| G0182 | Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patien | 440 | $30.6K | $69.45 | 1.74x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 409 | $28.0K | $68.50 | 3.37x |
| 99343 | New patient home visit, typically 45 minutes | 261 | $21.3K | $81.63 | 1.73x |
| 99327 | New patient assisted living visit, typically 60 minutes | 169 | $20.0K | $118.13 | 1.85x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 181 | $19.8K | $109.17 | 1.40x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 115 | $16.1K | $140.11 | 1.38x |
| 99348 | Established patient home visit, typically 25 minutes | 313 | $16.0K | $51.00 | 1.71x |
| 99326 | New patient assisted living visit, typically 45 minutes | 162 | $14.7K | $90.65 | 1.58x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 147 | $13.7K | $92.96 | 2.38x |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 294 | $11.9K | $40.40 | 1.85x |
This provider submits charges 1.85 times higher than what Medicare actually pays.
A markup ratio of 1.85x means for every $100 Medicare pays, this provider initially charges $185. 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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