This provider's $4.3M in total Medicare payments ranks in the 98th percentile of Nephrology providers nationally.
Medicare payments to this provider grew 83% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 82% in 2018
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 | $238.27 | $104.67 | 2.28x | $133.60 | $241.1K | 3.1K | 1.1K |
| 2015 | $203.44 | $81.16 | 2.51x | $122.28 | $291.0K | 3.7K | 915 |
| 2016 | $201.45 | $91.75 | 2.20x | $109.70 | $294.0K | 3.7K | 1.0K |
| 2017 | $182.49 | $83.21 | 2.19x | $99.28 | $327.4K | 4.0K | 1.7K |
| 2018 | $178.28 | $85.44 | 2.09x | $92.84 | $596.5K | 7.1K | 2.4K |
| 2019 | $193.32 | $100.93 | 1.92x | $92.39 | $614.9K | 6.9K | 1.6K |
| 2020 | $174.61 | $84.87 | 2.06x | $89.74 | $583.1K | 6.5K | 1.9K |
| 2021 | $168.35 | $86.62 | 1.94x | $81.73 | $532.6K | 6.3K | 2.0K |
| 2022 | $176.42 | $95.11 | 1.85x | $81.31 | $424.1K | 5.9K | 1.1K |
| 2023 | $206.00 | $95.90 | 2.15x | $110.10 | $440.0K | 7.2K | 1.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99336 | Established patient assisted living visit, typically 40 minutes | 11.6K | $1.1M | $98.91 | 1.76x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 8.9K | $621.4K | $69.46 | 2.41x |
| 99349 | Established patient home visit, typically 40 minutes | 5.0K | $471.1K | $93.94 | 1.89x |
| 99348 | Established patient home visit, typically 25 minutes | 8.3K | $469.7K | $56.52 | 2.66x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 4.8K | $331.7K | $69.15 | 2.32x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.2K | $173.3K | $79.33 | 2.78x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 2.7K | $141.6K | $51.77 | 2.90x |
| 99345 | New patient home visit, typically 75 minutes | 750 | $112.6K | $150.14 | 1.88x |
| 99328 | New patient assisted living visit, typically 75 minutes | 686 | $108.7K | $158.49 | 1.74x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 731 | $104.3K | $142.74 | 1.75x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 705 | $89.3K | $126.66 | 1.91x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.3K | $68.7K | $53.89 | 2.88x |
| 99327 | New patient assisted living visit, typically 60 minutes | 505 | $68.5K | $135.58 | 1.84x |
| 99350 | Established patient home visit, typically 60 minutes | 460 | $59.7K | $129.80 | 1.92x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 394 | $59.4K | $150.75 | 2.20x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 478 | $56.2K | $117.63 | 1.27x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 661 | $54.9K | $83.09 | 1.76x |
| G0179 | Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial im | 1.5K | $45.2K | $29.81 | 2.52x |
| G0181 | Physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of c | 499 | $29.1K | $58.39 | 1.29x |
| 99239 | Hospital discharge day management, more than 30 minutes | 266 | $21.5K | $80.86 | 3.27x |
This provider submits charges 2.14 times higher than what Medicare actually pays.
A markup ratio of 2.14x means for every $100 Medicare pays, this provider initially charges $214. 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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