This provider's $8.3M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 17012% from 2014 to 2023.
84% of their billing comes from a single procedure code (Q4205 — Membrane graft or membrane wrap, per square centimeter).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 2039% 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 |
|---|---|---|---|---|---|---|---|
| 2014 | $144.28 | $69.30 | 2.08x | $74.98 | $41.4K | 597 | 9 |
| 2015 | $156.83 | $65.86 | 2.38x | $90.97 | $72.8K | 1.1K | 9 |
| 2016 | $166.56 | $77.36 | 2.15x | $89.20 | $76.7K | 992 | 11 |
| 2017 | $181.98 | $70.29 | 2.59x | $111.69 | $79.9K | 1.1K | 9 |
| 2018 | $185.43 | $67.17 | 2.76x | $118.26 | $81.0K | 1.2K | 10 |
| 2019 | $180.76 | $71.11 | 2.54x | $109.65 | $59.7K | 840 | 7 |
| 2020 | $122.84 | $59.57 | 2.06x | $63.27 | $157.0K | 2.6K | 18 |
| 2021 | $219.23 | $98.32 | 2.23x | $120.91 | $355.1K | 3.6K | 19 |
| 2022 | $214.12 | $75.93 | 2.82x | $138.19 | $331.0K | 4.4K | 14 |
| 2023 | $1.1K | $849.08 | 1.33x | $283.95 | $7.1M | 8.3K | 12 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4205 | Membrane graft or membrane wrap, per square centimeter | 6.0K | $6.9M | $1.2K | 1.29x |
| 99336 | Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes | 4.1K | $350.9K | $86.59 | 2.98x |
| Q4206 | Fluid flow or fluid gf, 1 cc | 72 | $118.7K | $1.6K | 1.30x |
| 99335 | Established patient custodial care facility, group care, or assisted living visit, typically 25 minutes | 1.6K | $99.9K | $63.19 | 2.74x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 1.1K | $91.7K | $81.34 | 2.99x |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 1.8K | $89.7K | $49.65 | 3.08x |
| 99443 | Telephone medical discussion with physician, 21-30 minutes | 742 | $82.5K | $111.14 | 1.80x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.4K | $71.6K | $50.34 | 2.32x |
| 99442 | Telephone medical discussion with physician, 11-20 minutes | 1.1K | $70.6K | $64.88 | 2.49x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 474 | $52.3K | $110.33 | 1.92x |
| 99483 | Assessment of and care planning for patient with impaired thought processing, typically 60 minutes | 215 | $40.3K | $187.41 | 1.87x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 939 | $36.3K | $38.70 | 3.32x |
| 99358 | Extended patient service without direct patient contact, first hour | 354 | $34.1K | $96.35 | 2.08x |
| G0181 | Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow | 472 | $33.9K | $71.90 | 3.07x |
| 99344 | New patient home visit, typically 60 minutes | 253 | $30.5K | $120.53 | 2.04x |
| 99457 | Management using the results of remote vital sign monitoring per calendar month, first 20 minutes | 846 | $28.4K | $33.61 | 2.49x |
| 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 | 230 | $24.3K | $105.75 | 2.36x |
| 99326 | New patient custodial care facility, group care, or assisted living visit, typically 45 minutes | 251 | $20.2K | $80.39 | 2.16x |
| 99458 | Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes | 728 | $20.1K | $27.58 | 2.38x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 294 | $17.1K | $58.10 | 1.76x |
This provider submits charges 1.5 times higher than what Medicare actually pays.
A markup ratio of 1.5x means for every $100 Medicare pays, this provider initially charges $150. 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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