This provider's $4.7M in total Medicare payments ranks in the 98th percentile of Nephrology providers nationally.
Medicare payments to this provider grew 105% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 143% in 2015
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 | $187.31 | $87.42 | 2.14x | $99.89 | $161.9K | 2.2K | 1.6K |
| 2015 | $298.88 | $100.64 | 2.97x | $198.24 | $393.5K | 5.0K | 2.8K |
| 2016 | $249.68 | $91.09 | 2.74x | $158.59 | $522.1K | 5.8K | 2.6K |
| 2017 | $212.90 | $86.53 | 2.46x | $126.37 | $611.9K | 6.2K | 2.6K |
| 2018 | $230.09 | $90.47 | 2.54x | $139.62 | $589.5K | 6.3K | 2.6K |
| 2019 | $229.27 | $90.52 | 2.53x | $138.75 | $600.3K | 6.6K | 2.5K |
| 2020 | $231.21 | $94.11 | 2.46x | $137.10 | $610.5K | 6.2K | 2.5K |
| 2021 | $258.03 | $117.53 | 2.20x | $140.50 | $503.6K | 4.4K | 1.7K |
| 2022 | $226.11 | $98.27 | 2.30x | $127.84 | $366.6K | 3.6K | 1.5K |
| 2023 | $260.18 | $110.66 | 2.35x | $149.52 | $331.2K | 3.4K | 1.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 8.2K | $1.9M | $228.81 | 2.60x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 13.7K | $750.9K | $54.81 | 2.61x |
| 90935 | Hemodialysis procedure with one physician evaluation | 6.3K | $351.2K | $55.39 | 3.15x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 2.3K | $345.8K | $149.51 | 2.28x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.5K | $309.6K | $69.38 | 2.28x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 1.2K | $228.6K | $190.95 | 2.59x |
| 90966 | Home dialysis services per month, patient 20 years of age or older | 944 | $191.6K | $203.02 | 2.44x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 1.2K | $121.1K | $101.00 | 2.18x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 832 | $88.1K | $105.85 | 2.55x |
| 99238 | Hospital discharge day management, 30 minutes or less | 1.4K | $77.9K | $54.62 | 2.37x |
| 99239 | Hospital discharge day management, more than 30 minutes | 923 | $74.8K | $81.00 | 2.00x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 244 | $48.0K | $196.85 | 1.52x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 970 | $43.5K | $44.88 | 2.74x |
| 99220 | Hospital observation care typically 70 minutes per day | 262 | $35.2K | $134.43 | 1.47x |
| 90945 | Dialysis procedure including one evaluation | 505 | $32.5K | $64.34 | 4.58x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 909 | $26.5K | $29.19 | 3.01x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 164 | $23.1K | $140.60 | 3.16x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 247 | $12.3K | $49.77 | 2.86x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 174 | $11.8K | $67.61 | 2.22x |
| 81002 | Urinalysis, manual test | 3.1K | $10.7K | $3.42 | 2.92x |
This provider submits charges 2.56 times higher than what Medicare actually pays.
A markup ratio of 2.56x means for every $100 Medicare pays, this provider initially charges $256. 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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