This provider's $11.1M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 15058% from 2020 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1088% in 2022
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 |
|---|---|---|---|---|---|---|---|
| 2020 | $269.89 | $94.92 | 2.84x | $174.97 | $55.0K | 579 | 6 |
| 2021 | $279.22 | $126.03 | 2.22x | $153.19 | $208.6K | 1.7K | 7 |
| 2022 | $750.43 | $537.87 | 1.40x | $212.56 | $2.5M | 4.6K | 8 |
| 2023 | $1.1K | $765.09 | 1.41x | $313.50 | $8.3M | 10.9K | 8 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4262 | Dual layer impax membrane, per square centimeter | 6.3K | $5.8M | $922.77 | 1.39x |
| Q4253 | Zenith amniotic membrane, per square centimeter | 6.5K | $4.8M | $734.14 | 1.32x |
| 99336 | Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes | 1.8K | $154.2K | $86.76 | 3.15x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 1.3K | $104.6K | $81.29 | 3.99x |
| Q4205 | Membrane graft or membrane wrap, per square centimeter | 358 | $97.3K | $271.92 | 1.29x |
| 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 | 399 | $38.5K | $96.54 | 4.52x |
| 99335 | Established patient custodial care facility, group care, or assisted living visit, typically 25 minutes | 523 | $31.5K | $60.21 | 3.19x |
| 97610 | Therapy procedure using ultrasound | 93 | $26.4K | $283.41 | 1.59x |
| 99327 | New patient custodial care facility, group care, or assisted living visit, typically 1 hour | 120 | $13.7K | $114.24 | 3.43x |
| 99496 | Transitional care management services for problem of high complexity | 64 | $9.7K | $152.30 | 1.42x |
| 15275 | Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less | 59 | $6.1K | $103.51 | 2.56x |
| 99344 | Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes | 56 | $5.1K | $90.80 | 4.88x |
| 99337 | Established patient custodial care facility, group care, or assisted living visit, typically 1 hour | 36 | $4.7K | $130.06 | 2.89x |
| 99343 | New patient home visit, typically 45 minutes | 55 | $4.5K | $81.91 | 3.53x |
| G0180 | Physician or allowed practitioner 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 and | 32 | $1.1K | $34.14 | 6.83x |
| 15272 | Application of skin substitute graft to wound of trunk, arms, or legs, each additional 25.0 sq cm of wound 100.0 sq cm or less | 63 | $1.0K | $15.94 | 5.96x |
| G0179 | Physician or allowed practitioner re-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 a | 13 | $271.90 | $20.92 | 10.76x |
This provider submits charges 1.43 times higher than what Medicare actually pays.
A markup ratio of 1.43x means for every $100 Medicare pays, this provider initially charges $143. 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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