This provider's $3.3M in total Medicare payments ranks in the 97th 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 | $238.07 | $89.38 | 2.66x | $148.69 | $285.8K | 2.9K | 714 |
| 2015 | $235.97 | $84.94 | 2.78x | $151.03 | $300.6K | 3.2K | 868 |
| 2016 | $235.63 | $85.28 | 2.76x | $150.35 | $329.3K | 3.1K | 864 |
| 2017 | $254.98 | $84.58 | 3.01x | $170.40 | $299.6K | 2.5K | 710 |
| 2018 | $250.42 | $93.23 | 2.69x | $157.19 | $390.5K | 3.1K | 899 |
| 2019 | $250.72 | $92.51 | 2.71x | $158.21 | $423.4K | 3.4K | 882 |
| 2020 | $255.95 | $98.44 | 2.60x | $157.51 | $392.3K | 3.1K | 798 |
| 2021 | $271.10 | $117.46 | 2.31x | $153.64 | $349.0K | 2.5K | 612 |
| 2022 | $304.00 | $142.05 | 2.14x | $161.95 | $285.7K | 1.7K | 429 |
| 2023 | $275.06 | $119.42 | 2.30x | $155.64 | $210.3K | 1.1K | 261 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 8.7K | $1.9M | $214.60 | 3.49x |
| 90966 | Home dialysis services per month, patient 20 years of age or older | 2.9K | $574.6K | $197.71 | 2.28x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 1.3K | $249.9K | $185.93 | 2.69x |
| 90935 | Hemodialysis procedure with one physician evaluation | 4.5K | $240.9K | $53.78 | 3.72x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 6.3K | $179.8K | $28.60 | 2.09x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.1K | $58.0K | $53.38 | 1.50x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 890 | $44.8K | $50.34 | 1.70x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 149 | $20.4K | $136.75 | 2.18x |
| 90945 | Dialysis procedure including one evaluation | 151 | $9.4K | $62.07 | 3.22x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 88 | $6.5K | $73.52 | 1.63x |
| 90989 | Dialysis training completed | 11 | $3.8K | $344.85 | 1.74x |
| 90970 | Dialysis services, per day (less than full month service), patient 20 years of age or older | 448 | $2.8K | $6.28 | 2.39x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 89 | $2.3K | $26.33 | 2.48x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 15 | $1.2K | $77.72 | 1.42x |
This provider submits charges 3.08 times higher than what Medicare actually pays.
A markup ratio of 3.08x means for every $100 Medicare pays, this provider initially charges $308. 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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