This provider's $5.9M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 36073% from 2014 to 2023.
80% of their billing comes from a single procedure code (Q4262 — Dual layer impax membrane, per square centimeter).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 430744% 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 |
|---|---|---|---|---|---|---|---|
| 2014 | $6.5K | $88.07 | 74.21x | $6.4K | $16.3K | 185 | 7 |
| 2015 | $1.5K | $91.26 | 15.95x | $1.4K | $6.4K | 70 | 2 |
| 2018 | $4.1K | $96.14 | 42.48x | $4.0K | $2.4K | 25 | 2 |
| 2020 | $1.8K | $91.20 | 19.74x | $1.7K | $1.4K | 15 | 1 |
| 2023 | $1.3K | $1.0K | 1.32x | $322.34 | $5.9M | 5.8K | 3 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4262 | Dual layer impax membrane, per square centimeter | 4.6K | $4.7M | $1.0K | 1.32x |
| Q4276 | Orion, per square centimeter | 1.0K | $1.1M | $1.1K | 1.28x |
| 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 | 228 | $22.7K | $99.43 | 3.02x |
| 99235 | Hospital observation or inpatient care moderate severity, 50 minutes per day' | 107 | $11.7K | $109.30 | 12.81x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 36 | $3.3K | $92.62 | 14.69x |
| 99238 | Hospital discharge day management, 30 minutes or less | 50 | $2.4K | $48.58 | 21.82x |
| 22612 | Fusion of lower spine bones, posterior or posterolateral approach | 15 | $2.3K | $155.99 | 105.74x |
| 27447 | Repair of knee joint | 13 | $1.8K | $141.08 | 47.82x |
| 63030 | Partial removal of bone with release of spinal cord or spinal nerves of 1 interspace in lower spine | 16 | $1.6K | $101.15 | 327.47x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 30 | $1.5K | $48.63 | 15.22x |
| 99219 | Hospital observation care, typically 50 minutes | 15 | $1.4K | $91.20 | 19.74x |
| 63035 | Partial removal of bone with release of spinal cord or spinal nerves in upper or lower spine | 13 | $375.30 | $28.87 | 730.08x |
This provider submits charges 1.56 times higher than what Medicare actually pays.
A markup ratio of 1.56x means for every $100 Medicare pays, this provider initially charges $156. 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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