This provider's $20.0M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 6109% from 2021 to 2023.
61% of their billing comes from a single procedure code (Q4205 — Membrane graft or membrane wrap, per square centimeter).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 287504% in 2023
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 |
|---|---|---|---|---|---|---|---|
| 2021 | $366.59 | $247.15 | 1.48x | $119.44 | $316.8K | 1.3K | 7 |
| 2022 | $256.54 | $62.19 | 4.13x | $194.35 | $6.8K | 110 | 4 |
| 2023 | $1.3K | $761.47 | 1.65x | $495.66 | $19.7M | 25.8K | 8 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4205 | Membrane graft or membrane wrap, per square centimeter | 10.7K | $12.2M | $1.1K | 1.54x |
| Q4253 | Zenith amniotic membrane, per square centimeter | 13.3K | $7.1M | $531.64 | 1.79x |
| 97610 | Therapy procedure using ultrasound | 838 | $251.1K | $299.64 | 2.54x |
| Q4173 | Palingen or palingen xplus, per square centimeter | 640 | $145.3K | $227.01 | 1.39x |
| Q4178 | Floweramniopatch, per square centimeter | 412 | $139.3K | $338.16 | 1.33x |
| 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 | 963 | $100.3K | $104.16 | 2.56x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 116 | $12.3K | $105.99 | 4.26x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 143 | $11.7K | $82.05 | 2.56x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 47 | $5.4K | $114.41 | 5.29x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 74 | $3.3K | $44.27 | 3.55x |
| 99496 | Transitional care management services for problem of high complexity | 12 | $2.2K | $185.95 | 2.55x |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 11 | $537.58 | $48.87 | 4.48x |
This provider submits charges 1.65 times higher than what Medicare actually pays.
A markup ratio of 1.65x means for every $100 Medicare pays, this provider initially charges $165. This is lower 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.
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data