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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Providers
  3. Nicholas Bai
⚕️
PAIndividual

Nicholas Bai, PA

NPI: 1861748154
San Diego, CA
9 years of data
Physician Assistant
$19.7M
Total Payments
49
Beneficiaries
46.9K
Services
1.47x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$19.7M
Specialty median$22.5K

📋 Key Findings

1Billed $19.7M over 9 years
299th percentile in Physician Assistant by payments
3Payments surged 690% in 2021
✓ No flags detected

🔎 Data Analysis

This provider's $19.7M in total Medicare payments ranks in the 99th percentile of Physician Assistant providers nationally.

Medicare payments to this provider grew 2587% from 2015 to 2023.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

📈

Notable: Payments increased 690% in 2021

Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2015$163.03$99.271.64x$63.76$222.1K2.2K11
2016$371.79$129.332.87x$242.46$23.2K1792
2017$441.97$141.473.12x$300.50$51.8K3664
2018$311.94$106.982.92x$204.96$53.0K4954
2019$312.64$112.202.79x$200.44$103.8K9254
2020$331.74$123.902.68x$207.84$201.0K1.6K4
2021$402.12$219.041.84x$183.08$1.6M7.3K5
2022$692.53$514.751.35x$177.78$11.5M22.4K7
2023$798.27$522.701.53x$275.57$6.0M11.4K8

Top Procedures (17)

Q4253Zenith amniotic membrane, per square centimeter
$10.7M
15.7K services$678.94/svc1.35x markup
Q4248Dermacyte amniotic membrane allograft, per square centimeter
$3.5M
4.3K services$810.68/svc1.29x markup
Q4217Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter
$2.7M
6.4K services$414.56/svc1.25x markup
11043Removal of muscle and/or tissue, 20.0 sq cm or less
$1.5M
9.0K services$170.53/svc2.57x markup
Q4259Celera dual layer or celera dual membrane, per square centimeter
$576.3K
730 services$789.49/svc1.28x markup
11042Removal of skin and tissue, 20.0 sq cm or less
$417.1K
4.8K services$87.35/svc2.69x markup
11046Removal of muscle and/or tissue, each additional 20.0 sq cm or less
$141.6K
2.7K services$52.99/svc2.76x markup
15271Application 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
$124.9K
1.5K services$83.71/svc3.00x markup
99349Established patient home visit, typically 40 minutes
$35.2K
404 services$87.20/svc1.66x markup
49450Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast, accessed through the skin
$27.5K
56 services$490.78/svc2.70x markup
11045Removal of skin and tissue, each additional 20.0 sq cm or less
$26.9K
916 services$29.39/svc2.31x markup
99343New patient home visit, typically 45 minutes
$5.5K
61 services$90.22/svc1.55x markup
99344New patient home visit, typically 60 minutes
$5.2K
46 services$112.95/svc1.80x markup
99490Chronic care management services at least 20 minutes per calendar month
$4.9K
164 services$29.69/svc1.64x markup
93922Ultrasound study of arteries of both arms and legs
$4.0K
58 services$68.55/svc1.59x markup
99342New patient home visit, typically 30 minutes
$1.1K
19 services$56.99/svc1.51x markup
17250Application of chemical agent to excessive wound tissue
$628.92
21 services$29.95/svc1.67x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
Q4253Zenith amniotic membrane, per square centimeter15.7K$10.7M$678.941.35x
Q4248Dermacyte amniotic membrane allograft, per square centimeter4.3K$3.5M$810.681.29x
Q4217Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter6.4K$2.7M$414.561.25x
11043Removal of muscle and/or tissue, 20.0 sq cm or less9.0K$1.5M$170.532.57x
Q4259Celera dual layer or celera dual membrane, per square centimeter730$576.3K$789.491.28x
11042Removal of skin and tissue, 20.0 sq cm or less4.8K$417.1K$87.352.69x
11046Removal of muscle and/or tissue, each additional 20.0 sq cm or less2.7K$141.6K$52.992.76x
15271Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less1.5K$124.9K$83.713.00x
99349Established patient home visit, typically 40 minutes404$35.2K$87.201.66x
49450Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast, accessed through the skin56$27.5K$490.782.70x
11045Removal of skin and tissue, each additional 20.0 sq cm or less916$26.9K$29.392.31x
99343New patient home visit, typically 45 minutes61$5.5K$90.221.55x
99344New patient home visit, typically 60 minutes46$5.2K$112.951.80x
99490Chronic care management services at least 20 minutes per calendar month164$4.9K$29.691.64x
93922Ultrasound study of arteries of both arms and legs58$4.0K$68.551.59x
99342New patient home visit, typically 30 minutes19$1.1K$56.991.51x
17250Application of chemical agent to excessive wound tissue21$628.92$29.951.67x

Markup Analysis

Charge-to-Payment Ratio

1.47x

This provider submits charges 1.47 times higher than what Medicare actually pays.

What This Means

A markup ratio of 1.47x means for every $100 Medicare pays, this provider initially charges $147. This is lower than the national average.

Location

San Diego, CA

Provider Verification

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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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

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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