This provider's $4.3M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 843% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1004% in 2015
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 | $156.62 | $80.98 | 1.93x | $75.64 | $42.8K | 624 | 262 |
| 2015 | $145.59 | $79.34 | 1.84x | $66.25 | $473.1K | 8.6K | 3.0K |
| 2016 | $119.36 | $65.14 | 1.83x | $54.22 | $667.6K | 14.7K | 4.2K |
| 2017 | $138.74 | $75.62 | 1.83x | $63.12 | $613.1K | 15.1K | 3.6K |
| 2018 | $134.49 | $72.52 | 1.85x | $61.97 | $442.1K | 12.3K | 2.7K |
| 2019 | $134.61 | $74.40 | 1.81x | $60.21 | $516.5K | 13.5K | 2.9K |
| 2020 | $138.06 | $78.13 | 1.77x | $59.93 | $373.4K | 9.3K | 2.3K |
| 2021 | $134.56 | $76.37 | 1.76x | $58.19 | $455.8K | 11.4K | 2.8K |
| 2022 | $142.16 | $74.90 | 1.90x | $67.26 | $356.9K | 8.4K | 2.6K |
| 2023 | $144.10 | $76.42 | 1.89x | $67.68 | $404.1K | 8.4K | 2.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 62.1K | $1.8M | $28.44 | 2.28x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 13.0K | $678.5K | $52.09 | 1.92x |
| 90833 | Psychotherapy, 30 minutes with patient and/or family member | 13.2K | $596.2K | $45.32 | 1.80x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 5.2K | $385.3K | $74.53 | 1.68x |
| 90792 | Psychiatric diagnostic evaluation with medical services | 3.1K | $334.4K | $109.39 | 1.83x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 2.1K | $301.3K | $142.00 | 1.76x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 1.5K | $144.8K | $96.61 | 2.07x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 392 | $28.5K | $72.60 | 1.39x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 171 | $19.7K | $115.25 | 1.74x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 241 | $11.3K | $47.01 | 1.60x |
| 99328 | New patient assisted living visit, typically 75 minutes | 80 | $11.3K | $141.51 | 1.80x |
| 99334 | Established patient assisted living visit, typically 15 minutes | 260 | $10.0K | $38.39 | 1.95x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 305 | $9.4K | $30.73 | 1.63x |
| 90836 | Psychotherapy, 45 minutes with patient and/or family member | 141 | $8.2K | $57.99 | 1.73x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 110 | $7.4K | $67.24 | 1.49x |
| 99356 | Prolonged inpatient or observation hospital service first hour | 101 | $6.7K | $66.23 | 1.81x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 97 | $6.3K | $64.97 | 1.56x |
| 99238 | Hospital discharge day management, 30 minutes or less | 72 | $3.9K | $53.53 | 1.87x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 41 | $3.8K | $92.99 | 1.68x |
| 99239 | Hospital discharge day management, more than 30 minutes | 39 | $3.0K | $78.20 | 1.53x |
This provider submits charges 2.01 times higher than what Medicare actually pays.
A markup ratio of 2.01x means for every $100 Medicare pays, this provider initially charges $201. 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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