This provider's $4.8M in total Medicare payments ranks in the 98th percentile of Nephrology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $156.09 | $106.67 | 1.46x | $49.42 | $421.9K | 4.4K | 1.6K |
| 2015 | $163.38 | $106.34 | 1.54x | $57.04 | $463.1K | 4.7K | 1.6K |
| 2016 | $193.98 | $100.96 | 1.92x | $93.02 | $501.1K | 5.1K | 1.7K |
| 2017 | $157.39 | $98.16 | 1.60x | $59.23 | $461.3K | 4.5K | 1.6K |
| 2018 | $160.75 | $99.89 | 1.61x | $60.86 | $519.9K | 4.8K | 1.6K |
| 2019 | $163.00 | $99.53 | 1.64x | $63.47 | $514.5K | 4.0K | 1.4K |
| 2020 | $217.92 | $118.41 | 1.84x | $99.51 | $515.4K | 3.5K | 1.3K |
| 2021 | $278.63 | $135.51 | 2.06x | $143.12 | $571.6K | 3.3K | 1.1K |
| 2022 | $285.25 | $132.22 | 2.16x | $153.03 | $488.1K | 3.1K | 1.2K |
| 2023 | $341.13 | $126.56 | 2.70x | $214.57 | $375.3K | 2.8K | 1.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 6.7K | $1.5M | $222.70 | 1.64x |
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 4.0K | $1.1M | $286.21 | 1.62x |
| 90935 | Hemodialysis procedure with one physician evaluation | 7.0K | $448.5K | $64.34 | 1.69x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 3.3K | $402.9K | $122.08 | 1.57x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 5.0K | $322.9K | $65.00 | 1.60x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 1.6K | $274.7K | $167.28 | 1.82x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 6.6K | $235.7K | $35.72 | 1.66x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.9K | $189.5K | $98.67 | 1.93x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 998 | $78.7K | $78.84 | 2.63x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 379 | $55.9K | $147.60 | 2.25x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 855 | $51.5K | $60.25 | 2.61x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 650 | $39.1K | $60.09 | 1.45x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 97 | $17.1K | $176.36 | 1.32x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 140 | $15.9K | $113.70 | 1.37x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 159 | $14.2K | $89.61 | 2.12x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 138 | $13.0K | $94.03 | 1.78x |
| 90937 | Hemodialysis procedure with repeated evaluations | 129 | $11.8K | $91.68 | 1.52x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 335 | $11.7K | $35.05 | 1.64x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 39 | $5.7K | $146.43 | 1.30x |
| 99238 | Hospital discharge day management, 30 minutes or less | 88 | $5.6K | $63.58 | 1.33x |
This provider submits charges 1.69 times higher than what Medicare actually pays.
A markup ratio of 1.69x means for every $100 Medicare pays, this provider initially charges $169. This is lower than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Nephrology providers in NY for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Armistead Williams, M.D. | New York, NY | $37.6M | ✓ Clear |
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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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