This provider's $4.1M 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.
Notable: Payments increased 84% in 2019
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 | $230.82 | $108.11 | 2.14x | $122.71 | $420.5K | 3.9K | 2.0K |
| 2015 | $239.38 | $110.73 | 2.16x | $128.65 | $380.2K | 3.5K | 1.8K |
| 2016 | $229.14 | $99.72 | 2.30x | $129.42 | $370.9K | 3.5K | 1.8K |
| 2017 | $229.74 | $100.49 | 2.29x | $129.25 | $364.5K | 3.4K | 1.6K |
| 2018 | $257.39 | $112.34 | 2.29x | $145.05 | $380.9K | 3.4K | 1.6K |
| 2019 | $249.46 | $110.12 | 2.27x | $139.34 | $700.1K | 6.5K | 2.5K |
| 2020 | $277.83 | $120.12 | 2.31x | $157.71 | $364.4K | 3.1K | 1.3K |
| 2021 | $295.48 | $137.88 | 2.14x | $157.60 | $374.0K | 2.6K | 1.1K |
| 2022 | $275.93 | $112.80 | 2.45x | $163.13 | $390.6K | 4.1K | 1.5K |
| 2023 | $311.74 | $123.00 | 2.53x | $188.74 | $310.9K | 2.2K | 725 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 5.5K | $1.3M | $231.14 | 2.47x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 3.0K | $588.4K | $197.18 | 2.40x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 7.0K | $540.7K | $77.23 | 1.92x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 8.2K | $458.7K | $56.20 | 1.94x |
| 90966 | Home dialysis services per month, patient 20 years of age or older | 1.7K | $336.9K | $198.51 | 2.38x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 2.2K | $235.2K | $105.20 | 1.93x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 1.5K | $217.3K | $145.26 | 2.49x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.2K | $155.8K | $49.30 | 2.03x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.2K | $137.6K | $115.62 | 1.97x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 831 | $30.6K | $36.80 | 3.48x |
| 99457 | Management using the results of remote vital sign monitoring per calendar month, first 20 minutes | 831 | $29.5K | $35.46 | 3.61x |
| 99443 | Physician telephone patient service, 21-30 minutes of medical discussion | 287 | $23.3K | $81.17 | 1.77x |
| 90935 | Hemodialysis procedure with one physician evaluation | 224 | $12.7K | $56.49 | 2.29x |
| 99219 | Hospital observation care, typically 50 minutes | 58 | $6.0K | $103.63 | 2.32x |
| 99233 | Follow-up hospital inpatient care per day, typically 35 minutes | 53 | $4.0K | $75.93 | 1.98x |
| 99223 | Initial hospital inpatient care per day, typically 70 minutes | 22 | $3.4K | $153.81 | 1.85x |
| 90993 | Dialysis training, patient helper, course not completed | 207 | $3.2K | $15.68 | 4.15x |
| 99291 | Critical care, first 30-74 minutes | 22 | $3.0K | $137.70 | 4.00x |
| 93050 | Analysis of pressure of upper limb artery with interpretation and report | 191 | $2.4K | $12.33 | 3.38x |
| 99203 | New patient outpatient visit, total time 30-44 minutes | 28 | $2.3K | $83.59 | 1.85x |
This provider submits charges 2.27 times higher than what Medicare actually pays.
A markup ratio of 2.27x means for every $100 Medicare pays, this provider initially charges $227. 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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