This provider's $4.2M 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 | $256.00 | $88.37 | 2.90x | $167.63 | $367.6K | 4.3K | 2.0K |
| 2015 | $288.46 | $98.91 | 2.92x | $189.55 | $368.0K | 4.8K | 2.5K |
| 2016 | $276.88 | $97.91 | 2.83x | $178.97 | $489.5K | 7.6K | 3.2K |
| 2017 | $309.31 | $99.53 | 3.11x | $209.78 | $524.4K | 8.7K | 3.1K |
| 2018 | $331.67 | $109.07 | 3.04x | $222.60 | $544.3K | 8.0K | 2.9K |
| 2019 | $339.44 | $107.66 | 3.15x | $231.78 | $521.9K | 7.5K | 2.9K |
| 2020 | $309.17 | $95.93 | 3.22x | $213.24 | $332.3K | 4.4K | 1.8K |
| 2021 | $316.45 | $119.02 | 2.66x | $197.43 | $358.7K | 5.4K | 2.2K |
| 2022 | $427.14 | $148.11 | 2.88x | $279.03 | $347.9K | 4.3K | 1.9K |
| 2023 | $413.24 | $135.11 | 3.06x | $278.13 | $297.8K | 2.3K | 1.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 4.8K | $1.1M | $223.91 | 3.04x |
| 90966 | Home dialysis services per month, patient 20 years of age or older | 4.1K | $785.7K | $189.79 | 3.58x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 7.9K | $581.5K | $73.41 | 1.85x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 8.2K | $454.0K | $55.55 | 2.70x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 2.6K | $397.9K | $150.22 | 2.14x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 22.8K | $308.4K | $13.54 | 2.95x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 1.4K | $209.8K | $145.16 | 2.93x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 911 | $73.0K | $80.12 | 2.25x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.3K | $55.0K | $43.97 | 1.93x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 425 | $43.5K | $102.33 | 2.31x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 353 | $38.0K | $107.65 | 3.12x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 148 | $28.3K | $191.43 | 3.03x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 649 | $24.4K | $37.61 | 1.74x |
| 90989 | Dialysis training completed | 49 | $19.2K | $391.57 | 3.49x |
| 90935 | Hemodialysis procedure with one physician evaluation | 332 | $18.7K | $56.20 | 6.32x |
| 99441 | Physician telephone patient service, 5-10 minutes of medical discussion | 541 | $16.5K | $30.49 | 1.81x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 151 | $15.7K | $103.67 | 1.74x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 71 | $2.2K | $30.38 | 2.47x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 14 | $1.5K | $109.11 | 4.54x |
| 90970 | Dialysis services, per day (less than full month service), patient 20 years of age or older | 250 | $1.5K | $6.09 | 2.46x |
This provider submits charges 2.8 times higher than what Medicare actually pays.
A markup ratio of 2.8x means for every $100 Medicare pays, this provider initially charges $280. This is higher 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.
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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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