This provider's $4.2M in total Medicare payments ranks in the 98th percentile of Nephrology providers nationally.
Medicare payments to this provider grew 113% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
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 | $221.29 | $100.14 | 2.21x | $121.15 | $253.6K | 3.5K | 1.5K |
| 2015 | $278.37 | $105.10 | 2.65x | $173.27 | $265.7K | 3.5K | 1.5K |
| 2016 | $285.39 | $111.53 | 2.56x | $173.86 | $323.2K | 4.2K | 1.5K |
| 2017 | $263.91 | $99.19 | 2.66x | $164.72 | $445.2K | 6.2K | 2.0K |
| 2018 | $148.64 | $101.29 | 1.47x | $47.35 | $459.1K | 6.4K | 2.0K |
| 2019 | $155.15 | $109.57 | 1.42x | $45.58 | $427.6K | 5.5K | 1.8K |
| 2020 | $134.13 | $99.09 | 1.35x | $35.04 | $442.8K | 5.4K | 1.7K |
| 2021 | $230.46 | $113.25 | 2.03x | $117.21 | $486.3K | 5.4K | 1.8K |
| 2022 | $292.13 | $108.60 | 2.69x | $183.53 | $560.2K | 6.3K | 1.8K |
| 2023 | $343.76 | $126.89 | 2.71x | $216.87 | $541.3K | 5.7K | 1.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 21.0K | $1.2M | $58.35 | 2.03x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 9.0K | $757.7K | $84.46 | 2.26x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 6.0K | $504.1K | $83.91 | 2.11x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 4.3K | $456.5K | $106.91 | 2.10x |
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 1.2K | $330.6K | $264.66 | 2.15x |
| 90935 | Hemodialysis procedure with one physician evaluation | 5.5K | $321.9K | $58.46 | 2.13x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 751 | $166.6K | $221.84 | 2.18x |
| 90966 | Home dialysis services per month, patient 20 years of age or older | 665 | $139.4K | $209.64 | 2.01x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 541 | $85.7K | $158.33 | 2.15x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.3K | $82.6K | $62.27 | 2.44x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 362 | $45.0K | $124.29 | 2.28x |
| 99238 | Hospital discharge day management, 30 minutes or less | 285 | $16.1K | $56.40 | 1.94x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 95 | $14.5K | $152.80 | 2.04x |
| 90945 | Dialysis procedure including one evaluation | 184 | $12.6K | $68.61 | 2.00x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 175 | $10.7K | $61.13 | 2.13x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 334 | $10.4K | $31.06 | 2.17x |
| 90937 | Hemodialysis procedure with repeated evaluations | 122 | $9.9K | $81.22 | 2.67x |
| 99308 | Follow-up nursing facility visit per day, typically 15 minutes | 139 | $8.1K | $58.40 | 2.42x |
| 99441 | Physician telephone patient service, 5-10 minutes of medical discussion | 135 | $5.4K | $39.78 | 1.88x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 13 | $1.7K | $134.36 | 2.53x |
This provider submits charges 2.13 times higher than what Medicare actually pays.
A markup ratio of 2.13x means for every $100 Medicare pays, this provider initially charges $213. 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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