This provider's $11.6M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 22863% from 2014 to 2023.
67% of their billing comes from a single procedure code (Q4253 — Zenith amniotic membrane, per square centimeter).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 7857% in 2017
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 | $188.97 | $66.22 | 2.85x | $122.75 | $26.0K | 392 | 7 |
| 2015 | $162.44 | $72.12 | 2.25x | $90.32 | $29.6K | 411 | 11 |
| 2016 | $169.17 | $36.35 | 4.65x | $132.82 | $2.0K | 56 | 2 |
| 2017 | $169.14 | $80.07 | 2.11x | $89.07 | $162.0K | 2.0K | 9 |
| 2018 | $170.27 | $81.50 | 2.09x | $88.77 | $381.3K | 4.7K | 17 |
| 2019 | $162.52 | $73.39 | 2.21x | $89.13 | $173.9K | 2.4K | 13 |
| 2020 | $132.23 | $56.86 | 2.33x | $75.37 | $162.7K | 2.9K | 19 |
| 2021 | $153.92 | $63.78 | 2.41x | $90.14 | $173.8K | 2.7K | 17 |
| 2022 | $802.53 | $525.72 | 1.53x | $276.81 | $4.6M | 8.7K | 13 |
| 2023 | $802.91 | $604.03 | 1.33x | $198.88 | $6.0M | 9.9K | 18 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4253 | Zenith amniotic membrane, per square centimeter | 11.1K | $7.8M | $704.51 | 1.42x |
| Q4262 | Dual layer impax membrane, per square centimeter | 2.2K | $2.4M | $1.1K | 1.28x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 4.8K | $387.2K | $80.48 | 2.21x |
| 99336 | Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes | 2.6K | $217.7K | $85.01 | 2.20x |
| 99335 | Established patient custodial care facility, group care, or assisted living visit, typically 25 minutes | 3.3K | $191.2K | $58.35 | 2.35x |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 1.8K | $84.9K | $48.08 | 2.40x |
| G0181 | Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow | 1.2K | $82.0K | $69.65 | 2.17x |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 513 | $58.8K | $114.67 | 2.14x |
| 99344 | Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes | 463 | $49.1K | $105.95 | 2.41x |
| 99497 | Advance care planning, first 30 minutes | 870 | $47.1K | $54.15 | 1.71x |
| 15271 | Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less | 422 | $43.4K | $102.75 | 1.72x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 573 | $39.5K | $68.93 | 2.77x |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 825 | $33.6K | $40.79 | 2.62x |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 201 | $31.2K | $155.30 | 1.73x |
| 99345 | Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes | 146 | $20.8K | $142.40 | 2.12x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 447 | $20.2K | $45.15 | 3.04x |
| 99327 | New patient custodial care facility, group care, or assisted living visit, typically 1 hour | 138 | $16.1K | $116.76 | 2.29x |
| 99439 | Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month | 435 | $13.5K | $31.12 | 2.64x |
| 99204 | New patient outpatient visit, total time 45-59 minutes | 136 | $12.5K | $91.96 | 3.02x |
| 99354 | Prolonged office or other outpatient service first hour | 307 | $10.7K | $34.77 | 1.44x |
This provider submits charges 1.49 times higher than what Medicare actually pays.
A markup ratio of 1.49x means for every $100 Medicare pays, this provider initially charges $149. This is lower 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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