This provider's $10.2M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 2653% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1130% 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 |
|---|---|---|---|---|---|---|---|
| 2014 | $261.16 | $52.58 | 4.97x | $208.58 | $145.2K | 2.8K | 7 |
| 2015 | $299.07 | $50.23 | 5.95x | $248.84 | $212.3K | 4.2K | 9 |
| 2016 | $306.41 | $52.17 | 5.87x | $254.24 | $187.8K | 3.6K | 12 |
| 2017 | $131.79 | $44.03 | 2.99x | $87.76 | $208.8K | 4.7K | 15 |
| 2018 | $345.41 | $132.27 | 2.61x | $213.14 | $924.2K | 7.0K | 15 |
| 2019 | $212.58 | $69.87 | 3.04x | $142.71 | $517.7K | 7.4K | 16 |
| 2020 | $167.50 | $51.19 | 3.27x | $116.31 | $302.1K | 5.9K | 16 |
| 2021 | $173.33 | $53.49 | 3.24x | $119.84 | $279.5K | 5.2K | 14 |
| 2022 | $613.15 | $379.46 | 1.62x | $233.69 | $3.4M | 9.1K | 25 |
| 2023 | $831.66 | $543.26 | 1.53x | $288.40 | $4.0M | 7.4K | 15 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4253 | Zenith amniotic membrane, per square centimeter | 6.5K | $4.8M | $737.06 | 1.49x |
| Q4262 | Dual layer impax membrane, per square centimeter | 2.0K | $2.1M | $1.1K | 1.45x |
| 99232 | Follow-up hospital inpatient care per day, typically 25 minutes | 15.7K | $742.2K | $47.33 | 3.74x |
| Q4159 | Affinity, per square centimeter | 1.3K | $659.4K | $505.27 | 2.29x |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 6.2K | $285.4K | $46.12 | 4.48x |
| Q4163 | Woundex, bioskin, per square centimeter | 1.6K | $245.4K | $155.69 | 2.57x |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 2.0K | $211.6K | $103.91 | 4.59x |
| 99233 | Follow-up hospital inpatient care per day, typically 35 minutes | 2.8K | $192.2K | $68.57 | 2.63x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 2.2K | $157.8K | $72.67 | 2.58x |
| 11046 | Removal of muscle and/or tissue, each additional 20.0 sq cm or less | 3.6K | $138.2K | $38.51 | 4.12x |
| 11045 | Removal of skin and tissue, each additional 20.0 sq cm or less | 5.7K | $114.2K | $20.01 | 3.75x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 2.3K | $97.4K | $42.85 | 2.94x |
| 99222 | Initial hospital inpatient care per day, typically 50 minutes | 992 | $88.4K | $89.13 | 3.69x |
| 11047 | Removal of bone, each additional 20.0 sq cm or less | 1.3K | $86.1K | $67.92 | 4.18x |
| 11044 | Removal of bone, 20.0 sq cm or less | 480 | $74.8K | $155.86 | 4.60x |
| 97610 | Therapy procedure using ultrasound | 156 | $42.7K | $273.44 | 3.64x |
| 99223 | Initial hospital inpatient care per day, typically 70 minutes | 201 | $26.1K | $129.74 | 2.95x |
| 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 | 227 | $23.4K | $103.20 | 2.58x |
| 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 | 240 | $22.5K | $93.72 | 2.66x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 258 | $22.2K | $86.08 | 3.35x |
This provider submits charges 2.08 times higher than what Medicare actually pays.
A markup ratio of 2.08x means for every $100 Medicare pays, this provider initially charges $208. 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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