This provider's $4.2M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 13948% from 2022 to 2023.
66% of their billing comes from a single procedure code (Q4236 — Carepatch, per square centimeter).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 13948% 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 | $126.37 | $45.94 | 2.75x | $80.43 | $29.7K | 647 | 3 |
| 2023 | $1.1K | $779.49 | 1.41x | $322.17 | $4.2M | 5.4K | 11 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4236 | Carepatch, per square centimeter | 2.7K | $2.8M | $1.0K | 1.43x |
| Q4205 | Membrane graft or membrane wrap, per square centimeter | 1.1K | $1.3M | $1.1K | 1.28x |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 800 | $58.6K | $73.30 | 2.95x |
| 11045 | Removal of skin and tissue, each additional 20.0 sq cm or less | 979 | $23.9K | $24.41 | 2.54x |
| 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 | 138 | $13.0K | $93.99 | 3.85x |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 49 | $6.7K | $135.84 | 3.23x |
| 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 | 34 | $3.0K | $88.45 | 3.96x |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 63 | $2.8K | $44.66 | 2.13x |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 49 | $2.4K | $49.52 | 2.32x |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 33 | $2.2K | $66.54 | 1.88x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 14 | $1.1K | $78.54 | 2.14x |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | 20 | $834.08 | $41.70 | 2.11x |
| 99347 | Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes | 17 | $480.08 | $28.24 | 2.83x |
This provider submits charges 1.42 times higher than what Medicare actually pays.
A markup ratio of 1.42x means for every $100 Medicare pays, this provider initially charges $142. 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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