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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Providers
  3. James Sullivan
⚕️
DOIndividual

James Sullivan, D.O.

NPI: 1467560292
Reno, NV
10 years of data
Nephrology
$3.6M
Total Payments
13.5K
Beneficiaries
29.4K
Services
3.67x
Markup Ratio

Peer Comparison

97th
percentile in specialty
This provider$3.6M
Specialty median$185.2K

📋 Key Findings

1Billed $3.6M over 10 years
23.67x markup ratio (above median)
397th percentile in Nephrology by payments
418 procedures with >3x markup
✓ No flags detected

🔎 Data Analysis

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.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$322.80$90.013.59x$232.79$485.8K4.2K2.2K
2015$342.82$95.603.59x$247.22$499.2K4.4K2.2K
2016$342.74$95.333.60x$247.41$507.4K4.5K2.2K
2017$415.13$111.913.71x$303.22$381.8K3.0K1.3K
2018$398.36$104.153.82x$294.21$375.8K2.9K1.2K
2019$480.77$112.654.27x$368.12$276.1K2.4K1.0K
2020$530.92$130.924.06x$400.00$251.2K2.0K979
2021$509.75$144.373.53x$365.38$298.2K2.2K899
2022$437.96$123.873.54x$314.09$261.0K2.0K832
2023$425.45$134.983.15x$290.47$234.9K1.8K771

Top Procedures (20)

90960Dialysis services (4 or more physician visits per month), patient 20 years of age and older⚠ 3.7x markup
$837.2K
3.6K services$233.78/svc3.68x markup
99215Established patient office or other outpatient, visit typically 40 minutes⚠ 3.8x markup
$672.4K
6.5K services$103.07/svc3.82x markup
90966Home dialysis services per month, patient 20 years of age or older⚠ 3.5x markup
$599.1K
3.0K services$203.02/svc3.45x markup
99233Subsequent hospital inpatient care, typically 35 minutes per day⚠ 3.6x markup
$532.0K
6.4K services$82.69/svc3.61x markup
99214Established patient office or other outpatient, visit typically 25 minutes⚠ 3.9x markup
$275.9K
3.6K services$76.68/svc3.87x markup
90961Dialysis services (2-3 physician visits per month), patient 20 years of age and older⚠ 3.6x markup
$203.1K
1.0K services$196.46/svc3.65x markup
99223Initial hospital inpatient care, typically 70 minutes per day⚠ 3.7x markup
$126.2K
818 services$154.30/svc3.67x markup
99291Critical care delivery critically ill or injured patient, first 30-74 minutes⚠ 3.7x markup
$106.7K
604 services$176.74/svc3.73x markup
99232Subsequent hospital inpatient care, typically 25 minutes per day⚠ 3.5x markup
$52.2K
892 services$58.52/svc3.54x markup
99205New patient office or other outpatient visit, typically 60 minutes⚠ 3.9x markup
$43.7K
301 services$145.05/svc3.94x markup
90935Hemodialysis procedure with one physician evaluation⚠ 3.6x markup
$41.3K
711 services$58.09/svc3.65x markup
90962Dialysis services (1 physician visit per month), patient 20 years of age and older⚠ 3.9x markup
$31.7K
217 services$145.92/svc3.86x markup
99222Initial hospital inpatient care, typically 50 minutes per day⚠ 3.5x markup
$22.5K
216 services$104.39/svc3.52x markup
96372Injection beneath the skin or into muscle for therapy, diagnosis, or prevention⚠ 3.2x markup
$6.0K
311 services$19.30/svc3.21x markup
90989Dialysis training, patient helper, completed course⚠ 3.9x markup
$5.0K
13 services$387.51/svc3.87x markup
G0008Administration of influenza virus vaccine
$3.6K
139 services$25.56/svc2.35x markup
90970Dialysis services, per day (less than full month service), patient 20 years of age or older⚠ 4.2x markup
$2.5K
406 services$6.21/svc4.18x markup
99204New patient office or other outpatient visit, 45-59 minutes⚠ 4.0x markup
$2.5K
20 services$125.72/svc4.00x markup
99213Established patient office or other outpatient visit, typically 15 minutes⚠ 4.6x markup
$1.7K
37 services$47.25/svc4.56x markup
Q2037Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin)
$1.7K
111 services$15.69/svc2.55x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
90960Dialysis services (4 or more physician visits per month), patient 20 years of age and older3.6K$837.2K$233.783.68x
99215Established patient office or other outpatient, visit typically 40 minutes6.5K$672.4K$103.073.82x
90966Home dialysis services per month, patient 20 years of age or older3.0K$599.1K$203.023.45x
99233Subsequent hospital inpatient care, typically 35 minutes per day6.4K$532.0K$82.693.61x
99214Established patient office or other outpatient, visit typically 25 minutes3.6K$275.9K$76.683.87x
90961Dialysis services (2-3 physician visits per month), patient 20 years of age and older1.0K$203.1K$196.463.65x
99223Initial hospital inpatient care, typically 70 minutes per day818$126.2K$154.303.67x
99291Critical care delivery critically ill or injured patient, first 30-74 minutes604$106.7K$176.743.73x
99232Subsequent hospital inpatient care, typically 25 minutes per day892$52.2K$58.523.54x
99205New patient office or other outpatient visit, typically 60 minutes301$43.7K$145.053.94x
90935Hemodialysis procedure with one physician evaluation711$41.3K$58.093.65x
90962Dialysis services (1 physician visit per month), patient 20 years of age and older217$31.7K$145.923.86x
99222Initial hospital inpatient care, typically 50 minutes per day216$22.5K$104.393.52x
96372Injection beneath the skin or into muscle for therapy, diagnosis, or prevention311$6.0K$19.303.21x
90989Dialysis training, patient helper, completed course13$5.0K$387.513.87x
G0008Administration of influenza virus vaccine139$3.6K$25.562.35x
90970Dialysis services, per day (less than full month service), patient 20 years of age or older406$2.5K$6.214.18x
99204New patient office or other outpatient visit, 45-59 minutes20$2.5K$125.724.00x
99213Established patient office or other outpatient visit, typically 15 minutes37$1.7K$47.254.56x
Q2037Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin)111$1.7K$15.692.55x

Markup Analysis

Charge-to-Payment Ratio

3.67x

This provider submits charges 3.67 times higher than what Medicare actually pays.

What This Means

A markup ratio of 3.67x means for every $100 Medicare pays, this provider initially charges $367. This is higher than the national average.

Location

Reno, NV

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

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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