⚠️ This provider averages 778 services per working day — physically unusual for an individual practitioner
Based on 388.9K total services over 2 years (250 working days/year). Learn about impossible service volumes →
This provider's $4.9M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Averaging 778 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 20822% from 2022 to 2023.
93% of their billing comes from a single procedure code (Q4217 — Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 20822% in 2023
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 |
|---|---|---|---|---|---|---|---|
| 2022 | $149.23 | $61.45 | 2.43x | $87.78 | $23.1K | 376 | 5 |
| 2023 | $20.25 | $12.44 | 1.63x | $7.81 | $4.8M | 388.5K | 18 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4217 | Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter | 4.6K | $4.5M | $982.11 | 1.44x |
| J2406 | Injection, oritavancin (kimyrsa), 10 mg | 4.8K | $154.7K | $32.22 | 3.45x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 835 | $68.7K | $82.31 | 3.82x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 903 | $37.4K | $41.44 | 4.27x |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 227 | $17.8K | $78.41 | 4.26x |
| J0878 | Injection, daptomycin, 1 mg | 374.8K | $13.8K | $0.04 | 11.39x |
| 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 | 97 | $9.5K | $98.00 | 4.44x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 160 | $8.9K | $55.46 | 3.78x |
| J1335 | Injection, ertapenem sodium, 500 mg | 607 | $6.4K | $10.50 | 4.64x |
| 96367 | Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less | 294 | $5.5K | $18.83 | 4.34x |
| 97597 | Removal of tissue from wound, 20.0 sq cm or less | 68 | $4.4K | $65.21 | 3.43x |
| 96368 | Infusion into a vein for therapy, prevention, or diagnosis concurrent with another infusion | 333 | $4.3K | $12.79 | 4.50x |
| 36573 | Insertion of tube for infusion with imaging guidance and review by radiologist, patient 5 years or older | 17 | $4.2K | $249.65 | 3.25x |
| 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 | 40 | $4.1K | $101.60 | 4.20x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 34 | $3.5K | $102.68 | 4.75x |
| 29580 | Strapping, unna boot | 71 | $3.5K | $48.71 | 6.21x |
| 99211 | Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional | 148 | $2.2K | $14.86 | 2.83x |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 914 | $383.36 | $0.42 | 28.61x |
| 96372 | Injection of drug or substance under skin or into muscle | 19 | $176.13 | $9.27 | 4.01x |
This provider submits charges 1.63 times higher than what Medicare actually pays.
A markup ratio of 1.63x means for every $100 Medicare pays, this provider initially charges $163. 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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