This provider's $4.2M in total Medicare payments ranks in the 98th 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 | $123.22 | $43.23 | 2.85x | $79.99 | $419.0K | 10.3K | 4.7K |
| 2015 | $140.32 | $48.36 | 2.90x | $91.96 | $424.2K | 10.3K | 4.7K |
| 2016 | $130.75 | $46.69 | 2.80x | $84.06 | $451.6K | 10.9K | 5.0K |
| 2017 | $149.05 | $53.36 | 2.79x | $95.69 | $459.8K | 10.6K | 5.1K |
| 2018 | $148.94 | $51.26 | 2.91x | $97.68 | $493.5K | 13.3K | 6.8K |
| 2019 | $136.88 | $49.19 | 2.78x | $87.69 | $475.2K | 12.9K | 6.4K |
| 2020 | $127.03 | $48.64 | 2.61x | $78.39 | $434.0K | 9.8K | 5.1K |
| 2021 | $145.64 | $60.19 | 2.42x | $85.45 | $352.5K | 7.3K | 3.5K |
| 2022 | $164.67 | $63.11 | 2.61x | $101.56 | $304.2K | 7.3K | 3.6K |
| 2023 | $115.95 | $42.83 | 2.71x | $73.12 | $336.1K | 8.5K | 4.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 14.6K | $810.0K | $55.54 | 2.10x |
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 3.5K | $774.1K | $219.05 | 2.74x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.9K | $447.2K | $76.06 | 2.02x |
| 90966 | Home dialysis services per month, patient 20 years of age or older | 1.9K | $388.1K | $206.01 | 2.91x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 4.6K | $376.6K | $81.77 | 2.24x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.2K | $184.3K | $150.58 | 1.89x |
| 83970 | Parathormone (parathyroid hormone) level | 3.5K | $167.3K | $47.77 | 1.97x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.8K | $135.9K | $49.22 | 1.89x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 723 | $132.8K | $183.62 | 3.27x |
| 82306 | Vitamin D-3 level | 3.0K | $103.1K | $34.01 | 1.92x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 960 | $99.6K | $103.71 | 2.00x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 7.8K | $71.1K | $9.09 | 2.31x |
| 80048 | Blood test, basic group of blood chemicals | 6.6K | $55.9K | $8.43 | 2.96x |
| 83735 | Magnesium level | 6.5K | $50.9K | $7.87 | 2.03x |
| 82728 | Ferritin (blood protein) level | 2.3K | $37.7K | $16.32 | 2.33x |
| 90935 | Hemodialysis procedure with one physician evaluation | 672 | $37.0K | $55.13 | 6.35x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 280 | $31.1K | $110.92 | 2.25x |
| 84100 | Phosphate level | 6.2K | $29.9K | $4.80 | 3.33x |
| 36415 | Insertion of needle into vein for collection of blood sample | 7.8K | $27.2K | $3.48 | 4.32x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 185 | $25.5K | $138.07 | 4.33x |
This provider submits charges 2.47 times higher than what Medicare actually pays.
A markup ratio of 2.47x means for every $100 Medicare pays, this provider initially charges $247. 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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