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Methodology•Download Data
  1. Home
  2. Providers
  3. Kevin Pham
⚕️
MDIndividual

Kevin Pham, M.D.

NPI: 1477623635
Orange, CA
10 years of data
Nephrology
$5.0M
Total Payments
12.6K
Beneficiaries
45.5K
Services
2.31x
Markup Ratio

Peer Comparison

98th
percentile in specialty
This provider$5.0M
Specialty median$185.2K

📋 Key Findings

1Billed $5.0M over 10 years
22.31x markup ratio (above median)
398th percentile in Nephrology by payments
41 procedure with >3x markup
✓ No flags detected

🔎 Data Analysis

This provider's $5.0M 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.

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$264.75$111.492.37x$153.26$499.1K5.3K1.3K
2015$267.56$112.872.37x$154.69$462.6K4.7K1.3K
2016$279.47$116.102.41x$163.37$452.2K4.7K1.2K
2017$269.12$110.932.43x$158.19$447.2K5.2K1.2K
2018$310.12$130.172.38x$179.95$452.4K5.8K1.3K
2019$270.58$114.672.36x$155.91$497.8K5.1K1.4K
2020$307.83$132.452.32x$175.38$520.1K3.8K1.2K
2021$324.69$160.222.03x$164.47$590.1K3.8K1.2K
2022$352.33$172.812.04x$179.52$535.5K3.4K1.1K
2023$326.67$152.942.14x$173.73$522.7K3.8K1.3K

Top Procedures (19)

90960Dialysis services (4 or more physician visits per month), patient 20 years of age and older
$2.6M
9.9K services$263.83/svc2.36x markup
99213Established patient office or other outpatient visit, typically 15 minutes
$542.4K
8.9K services$60.83/svc2.24x markup
99232Subsequent hospital inpatient care, typically 25 minutes per day
$512.8K
8.3K services$62.10/svc2.21x markup
90966Home dialysis services per month, patient 20 years of age or older
$355.6K
1.6K services$216.68/svc2.28x markup
90935Hemodialysis procedure with one physician evaluation
$211.7K
3.4K services$61.68/svc2.35x markup
99223Initial hospital inpatient care, typically 70 minutes per day
$173.3K
1.0K services$167.30/svc2.22x markup
99222Initial hospital inpatient care, typically 50 minutes per day
$169.8K
1.5K services$114.78/svc2.20x markup
90961Dialysis services (2-3 physician visits per month), patient 20 years of age and older
$144.3K
671 services$215.01/svc2.33x markup
99204New patient office or other outpatient visit, typically 45 minutes
$116.0K
850 services$136.50/svc2.28x markup
90970Dialysis services, per day (less than full month service), patient 20 years of age or older
$53.9K
8.1K services$6.67/svc2.62x markup
99442Physician telephone patient service, 11-20 minutes of medical discussion
$22.0K
337 services$65.14/svc2.09x markup
90962Dialysis services (1 physician visit per month), patient 20 years of age and older
$21.1K
133 services$158.98/svc2.15x markup
90945Dialysis procedure including one evaluation
$18.5K
255 services$72.58/svc2.08x markup
99233Subsequent hospital inpatient care, typically 35 minutes per day
$7.9K
87 services$90.38/svc2.18x markup
99221Initial hospital inpatient care, typically 30 minutes per day
$6.9K
80 services$86.70/svc2.12x markup
G0180Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple
$2.4K
53 services$45.99/svc2.65x markup
96372Injection beneath the skin or into muscle for therapy, diagnosis, or prevention⚠ 3.5x markup
$2.2K
151 services$14.49/svc3.45x markup
99231Subsequent hospital inpatient care, typically 15 minutes per day
$1.4K
44 services$31.99/svc2.41x markup
81002Urinalysis, manual test
$232.14
68 services$3.41/svc2.05x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
90960Dialysis services (4 or more physician visits per month), patient 20 years of age and older9.9K$2.6M$263.832.36x
99213Established patient office or other outpatient visit, typically 15 minutes8.9K$542.4K$60.832.24x
99232Subsequent hospital inpatient care, typically 25 minutes per day8.3K$512.8K$62.102.21x
90966Home dialysis services per month, patient 20 years of age or older1.6K$355.6K$216.682.28x
90935Hemodialysis procedure with one physician evaluation3.4K$211.7K$61.682.35x
99223Initial hospital inpatient care, typically 70 minutes per day1.0K$173.3K$167.302.22x
99222Initial hospital inpatient care, typically 50 minutes per day1.5K$169.8K$114.782.20x
90961Dialysis services (2-3 physician visits per month), patient 20 years of age and older671$144.3K$215.012.33x
99204New patient office or other outpatient visit, typically 45 minutes850$116.0K$136.502.28x
90970Dialysis services, per day (less than full month service), patient 20 years of age or older8.1K$53.9K$6.672.62x
99442Physician telephone patient service, 11-20 minutes of medical discussion337$22.0K$65.142.09x
90962Dialysis services (1 physician visit per month), patient 20 years of age and older133$21.1K$158.982.15x
90945Dialysis procedure including one evaluation255$18.5K$72.582.08x
99233Subsequent hospital inpatient care, typically 35 minutes per day87$7.9K$90.382.18x
99221Initial hospital inpatient care, typically 30 minutes per day80$6.9K$86.702.12x
G0180Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple53$2.4K$45.992.65x
96372Injection beneath the skin or into muscle for therapy, diagnosis, or prevention151$2.2K$14.493.45x
99231Subsequent hospital inpatient care, typically 15 minutes per day44$1.4K$31.992.41x
81002Urinalysis, manual test68$232.14$3.412.05x

Markup Analysis

Charge-to-Payment Ratio

2.31x

This provider submits charges 2.31 times higher than what Medicare actually pays.

What This Means

A markup ratio of 2.31x means for every $100 Medicare pays, this provider initially charges $231. This is higher than the national average.

Location

Orange, CA

Provider Verification

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

Similar Providers

Other Nephrology providers in CA for peer comparison.

Kevin Pham (you)
$5.0M
Feliciano Serrano, M.D.
$45.3M
Show detailed table ▾
ProviderLocationTotal PaymentsStatus
Feliciano Serrano, M.D.Huntington Park, CA$45.3M✓ Clear

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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.

Believe this data is inaccurate? Dispute this data