This provider's $4.6M in total Medicare payments ranks in the 98th percentile of Nephrology providers nationally.
Medicare payments to this provider grew 97% 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 | $275.38 | $93.65 | 2.94x | $181.73 | $354.0K | 4.5K | 1.9K |
| 2015 | $275.40 | $92.61 | 2.97x | $182.79 | $322.1K | 3.9K | 1.6K |
| 2016 | $285.80 | $104.80 | 2.73x | $181.00 | $441.1K | 4.7K | 1.7K |
| 2017 | $400.00 | $125.13 | 3.20x | $274.87 | $391.9K | 4.1K | 1.7K |
| 2018 | $408.30 | $132.54 | 3.08x | $275.76 | $395.1K | 3.9K | 1.7K |
| 2019 | $340.03 | $116.95 | 2.91x | $223.08 | $380.8K | 3.9K | 1.6K |
| 2020 | $298.25 | $103.76 | 2.87x | $194.49 | $433.8K | 4.5K | 1.9K |
| 2021 | $292.73 | $124.90 | 2.34x | $167.83 | $646.9K | 6.2K | 2.4K |
| 2022 | $261.15 | $106.97 | 2.44x | $154.18 | $570.9K | 6.6K | 2.7K |
| 2023 | $254.29 | $110.26 | 2.31x | $144.03 | $697.1K | 8.7K | 2.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 20.0K | $1.6M | $81.97 | 1.83x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 10.5K | $818.8K | $78.05 | 2.08x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 3.6K | $547.8K | $153.59 | 2.12x |
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 1.5K | $361.6K | $243.32 | 3.02x |
| 90966 | Home dialysis services per month, patient 20 years of age or older | 1.5K | $278.9K | $187.70 | 3.93x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 3.7K | $164.5K | $44.70 | 2.25x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 674 | $140.0K | $207.65 | 3.50x |
| 99443 | Physician telephone patient service, 21-30 minutes of medical discussion | 1.5K | $126.1K | $81.98 | 2.13x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 886 | $106.4K | $120.09 | 1.52x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 871 | $100.5K | $115.41 | 1.68x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 910 | $95.2K | $104.59 | 1.91x |
| 99439 | Chronic care management services, each additional 20 minutes of clinical staff time per calendar month | 1.3K | $52.2K | $39.19 | 1.95x |
| 90989 | Dialysis training, patient helper, completed course | 164 | $48.6K | $296.39 | 2.53x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 217 | $32.0K | $147.61 | 4.98x |
| 99495 | Transitional care management services for problem of at least moderate complexity | 184 | $26.6K | $144.34 | 2.42x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 350 | $14.6K | $41.85 | 2.16x |
| 99457 | Management using the results of remote vital sign monitoring per calendar month, first 20 minutes | 359 | $14.4K | $40.05 | 2.00x |
| 99496 | Transitional care management services for problem of high complexity | 75 | $13.9K | $184.91 | 2.68x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 240 | $13.7K | $57.18 | 2.47x |
| 99205 | New patient outpatient visit, total time 60-74 minutes | 45 | $8.3K | $184.85 | 1.35x |
This provider submits charges 2.24 times higher than what Medicare actually pays.
A markup ratio of 2.24x means for every $100 Medicare pays, this provider initially charges $224. 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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