This provider's $4.0M 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 | $267.81 | $97.66 | 2.74x | $170.15 | $414.2K | 3.3K | 1.3K |
| 2015 | $280.67 | $100.14 | 2.80x | $180.53 | $393.1K | 3.1K | 1.3K |
| 2016 | $287.26 | $98.28 | 2.92x | $188.98 | $442.8K | 3.4K | 1.3K |
| 2017 | $318.64 | $106.40 | 2.99x | $212.24 | $407.0K | 3.2K | 1.2K |
| 2018 | $318.53 | $110.99 | 2.87x | $207.54 | $449.9K | 3.2K | 1.2K |
| 2019 | $243.40 | $96.96 | 2.51x | $146.44 | $415.2K | 2.9K | 1.2K |
| 2020 | $248.02 | $113.63 | 2.18x | $134.39 | $395.4K | 2.4K | 962 |
| 2021 | $297.22 | $161.58 | 1.84x | $135.64 | $421.9K | 2.1K | 677 |
| 2022 | $287.50 | $151.86 | 1.89x | $135.64 | $345.7K | 1.8K | 619 |
| 2023 | $275.00 | $138.87 | 1.98x | $136.13 | $305.0K | 1.6K | 591 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 6.5K | $1.4M | $220.58 | 2.04x |
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 4.5K | $1.2M | $257.46 | 2.18x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 3.5K | $559.4K | $161.03 | 1.86x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.5K | $385.3K | $85.02 | 2.35x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 2.7K | $163.9K | $61.33 | 3.26x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.2K | $68.9K | $57.86 | 2.59x |
| 90935 | Hemodialysis procedure with one physician evaluation | 1.1K | $65.1K | $61.56 | 10.10x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 401 | $46.2K | $115.29 | 2.17x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 230 | $31.5K | $136.77 | 2.19x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 158 | $27.1K | $171.54 | 2.19x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 247 | $21.6K | $87.62 | 2.57x |
| 99239 | Hospital discharge day management, more than 30 minutes | 67 | $6.2K | $92.01 | 2.72x |
| 36415 | Insertion of needle into vein for collection of blood sample | 1.7K | $5.1K | $2.94 | 10.20x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 18 | $1.9K | $102.90 | 2.67x |
| G0008 | Administration of influenza virus vaccine | 65 | $1.7K | $26.25 | 2.42x |
| Q2037 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin) | 43 | $665.05 | $15.47 | 4.06x |
| 90674 | Vaccine for influenza for administration into muscle, 0.5 ml dosage | 17 | $468.69 | $27.57 | 3.63x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 17 | $166.54 | $9.80 | 7.66x |
This provider submits charges 2.3 times higher than what Medicare actually pays.
A markup ratio of 2.3x means for every $100 Medicare pays, this provider initially charges $230. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data