This provider's $9.9M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 81685% from 2020 to 2023.
70% of their billing comes from a single procedure code (Q4217 — Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 123547% 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 |
|---|---|---|---|---|---|---|---|
| 2020 | $181.26 | $66.73 | 2.72x | $114.53 | $12.0K | 180 | 5 |
| 2021 | $363.50 | $68.70 | 5.29x | $294.80 | $8.7K | 127 | 5 |
| 2022 | $735.66 | $65.12 | 11.30x | $670.54 | $7.9K | 122 | 6 |
| 2023 | $1.3K | $991.07 | 1.34x | $337.25 | $9.8M | 9.9K | 16 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4217 | Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter | 6.1K | $6.9M | $1.1K | 1.31x |
| Q4277 | Woundplus membrane or e-graft, per square centimeter | 2.0K | $2.8M | $1.4K | 1.30x |
| 97610 | Therapy procedure using ultrasound | 206 | $55.1K | $267.52 | 2.99x |
| 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 | 244 | $22.9K | $93.70 | 4.34x |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 225 | $10.6K | $47.01 | 3.55x |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 138 | $9.3K | $67.73 | 4.77x |
| 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 | 77 | $7.6K | $99.18 | 3.18x |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 128 | $6.2K | $48.17 | 4.10x |
| 99285 | Emergency department visit for life threatening or functioning severity | 50 | $5.9K | $117.39 | 10.24x |
| 0598T | Fluorescence wound imaging for bacteria, first anatomic site | 51 | $4.7K | $92.91 | 2.97x |
| 99203 | New patient outpatient visit, total time 30-44 minutes | 61 | $4.7K | $76.51 | 2.69x |
| 97597 | Removal of tissue from wound, 20.0 sq cm or less | 77 | $4.7K | $60.47 | 3.27x |
| 99284 | Emergency department visit for problem of high severity | 58 | $4.3K | $74.97 | 9.54x |
| 87426 | Elisa detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 96 | $4.3K | $45.23 | 1.87x |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | 43 | $3.7K | $84.92 | 3.17x |
| 99307 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes | 126 | $3.2K | $25.13 | 3.29x |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 25 | $2.9K | $116.21 | 2.95x |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 20 | $2.8K | $141.19 | 3.31x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 18 | $2.6K | $146.07 | 4.15x |
| 99202 | New patient outpatient visit, total time 15-29 minutes | 41 | $2.4K | $58.93 | 2.39x |
This provider submits charges 1.35 times higher than what Medicare actually pays.
A markup ratio of 1.35x means for every $100 Medicare pays, this provider initially charges $135. 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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