This provider's $3.6M in total Medicare payments ranks in the 97th 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 | $322.80 | $90.01 | 3.59x | $232.79 | $485.8K | 4.2K | 2.2K |
| 2015 | $342.82 | $95.60 | 3.59x | $247.22 | $499.2K | 4.4K | 2.2K |
| 2016 | $342.74 | $95.33 | 3.60x | $247.41 | $507.4K | 4.5K | 2.2K |
| 2017 | $415.13 | $111.91 | 3.71x | $303.22 | $381.8K | 3.0K | 1.3K |
| 2018 | $398.36 | $104.15 | 3.82x | $294.21 | $375.8K | 2.9K | 1.2K |
| 2019 | $480.77 | $112.65 | 4.27x | $368.12 | $276.1K | 2.4K | 1.0K |
| 2020 | $530.92 | $130.92 | 4.06x | $400.00 | $251.2K | 2.0K | 979 |
| 2021 | $509.75 | $144.37 | 3.53x | $365.38 | $298.2K | 2.2K | 899 |
| 2022 | $437.96 | $123.87 | 3.54x | $314.09 | $261.0K | 2.0K | 832 |
| 2023 | $425.45 | $134.98 | 3.15x | $290.47 | $234.9K | 1.8K | 771 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 3.6K | $837.2K | $233.78 | 3.68x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 6.5K | $672.4K | $103.07 | 3.82x |
| 90966 | Home dialysis services per month, patient 20 years of age or older | 3.0K | $599.1K | $203.02 | 3.45x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 6.4K | $532.0K | $82.69 | 3.61x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.6K | $275.9K | $76.68 | 3.87x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 1.0K | $203.1K | $196.46 | 3.65x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 818 | $126.2K | $154.30 | 3.67x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 604 | $106.7K | $176.74 | 3.73x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 892 | $52.2K | $58.52 | 3.54x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 301 | $43.7K | $145.05 | 3.94x |
| 90935 | Hemodialysis procedure with one physician evaluation | 711 | $41.3K | $58.09 | 3.65x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 217 | $31.7K | $145.92 | 3.86x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 216 | $22.5K | $104.39 | 3.52x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 311 | $6.0K | $19.30 | 3.21x |
| 90989 | Dialysis training, patient helper, completed course | 13 | $5.0K | $387.51 | 3.87x |
| G0008 | Administration of influenza virus vaccine | 139 | $3.6K | $25.56 | 2.35x |
| 90970 | Dialysis services, per day (less than full month service), patient 20 years of age or older | 406 | $2.5K | $6.21 | 4.18x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 20 | $2.5K | $125.72 | 4.00x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 37 | $1.7K | $47.25 | 4.56x |
| Q2037 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin) | 111 | $1.7K | $15.69 | 2.55x |
This provider submits charges 3.67 times higher than what Medicare actually pays.
A markup ratio of 3.67x means for every $100 Medicare pays, this provider initially charges $367. 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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