This provider's $9.5M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 43450% from 2020 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 2019% in 2022
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 |
|---|---|---|---|---|---|---|---|
| 2020 | $238.37 | $106.51 | 2.24x | $131.86 | $15.8K | 148 | 5 |
| 2021 | $254.45 | $118.27 | 2.15x | $136.18 | $119.4K | 1.0K | 11 |
| 2022 | $650.74 | $469.66 | 1.39x | $181.08 | $2.5M | 5.4K | 14 |
| 2023 | $1.1K | $807.20 | 1.32x | $254.28 | $6.9M | 8.5K | 13 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4262 | Dual layer impax membrane, per square centimeter | 5.1K | $5.3M | $1.0K | 1.30x |
| Q4253 | Zenith amniotic membrane, per square centimeter | 5.0K | $3.7M | $744.76 | 1.28x |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 1.8K | $201.0K | $113.84 | 2.43x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 843 | $63.7K | $75.59 | 2.63x |
| 99345 | Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes | 275 | $33.5K | $121.89 | 2.81x |
| 15271 | Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less | 321 | $32.8K | $102.18 | 2.69x |
| 99496 | Transitional care management services for problem of high complexity | 150 | $27.4K | $182.99 | 2.04x |
| 99483 | Assessment of and care planning for impaired thought processing, typically 50 minutes | 140 | $25.9K | $185.30 | 1.58x |
| 99337 | Established patient custodial care facility, group care, or assisted living visit, typically 1 hour | 180 | $22.8K | $126.74 | 2.36x |
| 99442 | Telephone medical discussion with physician, 11-20 minutes | 344 | $17.1K | $49.62 | 2.02x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 122 | $13.7K | $112.26 | 1.58x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 90 | $13.1K | $145.70 | 1.79x |
| 99497 | Advance care planning, first 30 minutes | 180 | $10.0K | $55.76 | 2.36x |
| 99344 | Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes | 66 | $7.5K | $114.23 | 2.45x |
| 99443 | Telephone medical discussion with physician, 21-30 minutes | 107 | $6.7K | $62.61 | 2.32x |
| 99328 | New patient custodial care facility, group care, or assisted living visit, typically 75 minutes | 35 | $3.9K | $111.01 | 3.05x |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 57 | $3.0K | $53.21 | 1.92x |
| G0181 | Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow | 39 | $2.9K | $73.44 | 2.24x |
| 96130 | Evaluation of psychological test, first hour | 28 | $2.3K | $82.06 | 1.96x |
| G0180 | Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and | 47 | $1.7K | $36.01 | 2.27x |
This provider submits charges 1.35 times higher than what Medicare actually pays.
A markup ratio of 1.35x means for every $100 Medicare pays, this provider initially charges $135. This is lower 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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