This provider's $4.7M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 119226% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 5567% in 2016
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 | $48.02 | $24.05 | 2.00x | $23.97 | $1.4K | 58 | 58 |
| 2016 | $243.82 | $73.04 | 3.34x | $170.78 | $79.7K | 1.1K | 787 |
| 2017 | $286.79 | $72.72 | 3.94x | $214.07 | $222.8K | 3.4K | 1.5K |
| 2018 | $306.94 | $73.14 | 4.20x | $233.80 | $170.2K | 2.7K | 1.1K |
| 2019 | $199.96 | $78.14 | 2.56x | $121.82 | $355.3K | 5.3K | 1.8K |
| 2020 | $213.65 | $84.49 | 2.53x | $129.16 | $699.8K | 11.0K | 2.8K |
| 2021 | $214.01 | $85.13 | 2.51x | $128.88 | $578.7K | 8.1K | 2.7K |
| 2022 | $209.51 | $83.65 | 2.50x | $125.86 | $867.0K | 11.2K | 3.3K |
| 2023 | $200.80 | $88.65 | 2.27x | $112.15 | $1.7M | 19.4K | 5.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 15.9K | $1.0M | $65.14 | 3.13x |
| 90837 | Psychotherapy, 60 minutes | 7.3K | $678.5K | $93.21 | 2.15x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 7.4K | $675.1K | $91.11 | 2.68x |
| 90834 | Psychotherapy, 45 minutes | 8.8K | $570.9K | $64.67 | 2.32x |
| 99350 | Established patient home visit, typically 60 minutes | 3.5K | $443.9K | $125.41 | 2.14x |
| 90792 | Psychiatric diagnostic evaluation with medical services | 3.2K | $357.7K | $111.23 | 2.46x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 2.9K | $333.9K | $117.13 | 2.38x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 827 | $77.8K | $94.10 | 2.75x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 1.8K | $76.1K | $42.86 | 4.26x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 538 | $71.4K | $132.67 | 2.27x |
| 99497 | Advance care planning, first 30 minutes | 1.2K | $63.5K | $53.27 | 3.00x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 944 | $58.4K | $61.88 | 3.91x |
| 99349 | Established patient home visit, typically 40 minutes | 546 | $46.7K | $85.59 | 1.88x |
| 99327 | New patient assisted living visit, typically 60 minutes | 328 | $41.3K | $126.03 | 2.20x |
| 99407 | Smoking and tobacco use intensive counseling, greater than 10 minutes | 1.6K | $38.1K | $24.47 | 3.89x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 259 | $22.1K | $85.49 | 3.68x |
| 96127 | Brief emotional or behavioral assessment | 4.8K | $18.6K | $3.92 | 25.45x |
| 99345 | Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes | 85 | $11.4K | $133.55 | 2.15x |
| 99326 | New patient assisted living visit, typically 45 minutes | 112 | $10.7K | $95.26 | 2.30x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 72 | $9.5K | $131.65 | 2.28x |
This provider submits charges 2.7 times higher than what Medicare actually pays.
A markup ratio of 2.7x means for every $100 Medicare pays, this provider initially charges $270. 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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