This provider's $12.8M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 1430% from 2020 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 405% in 2021
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 | $328.65 | $186.35 | 1.76x | $142.30 | $404.4K | 2.2K | 8 |
| 2021 | $515.64 | $243.56 | 2.12x | $272.08 | $2.0M | 8.4K | 13 |
| 2022 | $868.21 | $496.14 | 1.75x | $372.07 | $4.2M | 8.4K | 11 |
| 2023 | $1.1K | $731.22 | 1.55x | $402.67 | $6.2M | 8.5K | 12 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4262 | Dual layer impax membrane, per square centimeter | 5.0K | $4.9M | $983.30 | 1.52x |
| Q4253 | Zenith amniotic membrane, per square centimeter | 5.7K | $4.1M | $732.77 | 1.52x |
| Q4254 | Novafix dl, per square centimeter | 5.3K | $2.1M | $393.41 | 2.37x |
| Q4197 | Puraply xt, per square centimeter | 6.0K | $1.3M | $210.18 | 1.67x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 951 | $76.8K | $80.79 | 2.76x |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 931 | $66.9K | $71.90 | 2.91x |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 572 | $65.8K | $114.98 | 2.70x |
| 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 | 397 | $39.8K | $100.27 | 2.65x |
| 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 | 337 | $31.4K | $93.13 | 2.71x |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 194 | $29.0K | $149.64 | 2.69x |
| 11045 | Removal of skin and tissue, each additional 20.0 sq cm or less | 859 | $23.0K | $26.75 | 2.71x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 246 | $20.3K | $82.46 | 2.26x |
| 99344 | Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes | 167 | $17.9K | $107.40 | 2.94x |
| 11047 | Removal of skin and bone | 121 | $10.3K | $85.44 | 2.56x |
| 11044 | Removal of bone, 20.0 sq cm or less | 50 | $10.3K | $205.13 | 2.67x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 135 | $7.4K | $54.99 | 2.31x |
| 11046 | Removal of muscle and/or tissue, each additional 20.0 sq cm or less | 118 | $5.8K | $49.53 | 2.61x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 38 | $4.4K | $116.76 | 2.14x |
| 99348 | Established patient home visit, typically 25 minutes | 50 | $2.7K | $54.41 | 2.68x |
| 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 | 149 | $2.4K | $16.38 | 2.85x |
This provider submits charges 1.71 times higher than what Medicare actually pays.
A markup ratio of 1.71x means for every $100 Medicare pays, this provider initially charges $171. 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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