This provider's $5.1M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 8561% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 6557% 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 |
|---|---|---|---|---|---|---|---|
| 2014 | $36.12 | $14.81 | 2.44x | $21.31 | $52.7K | 3.6K | 14 |
| 2015 | $41.87 | $17.74 | 2.36x | $24.13 | $68.8K | 3.9K | 17 |
| 2016 | $43.35 | $19.43 | 2.23x | $23.92 | $63.7K | 3.3K | 18 |
| 2017 | $48.01 | $20.31 | 2.36x | $27.70 | $62.3K | 3.1K | 21 |
| 2018 | $52.60 | $24.19 | 2.17x | $28.41 | $59.4K | 2.5K | 23 |
| 2019 | $54.72 | $23.00 | 2.38x | $31.72 | $40.6K | 1.8K | 19 |
| 2020 | $58.76 | $25.58 | 2.30x | $33.18 | $45.6K | 1.8K | 19 |
| 2021 | $52.01 | $23.60 | 2.20x | $28.41 | $59.6K | 2.5K | 25 |
| 2022 | $109.12 | $41.43 | 2.63x | $67.69 | $68.6K | 1.7K | 21 |
| 2023 | $974.76 | $682.29 | 1.43x | $292.47 | $4.6M | 6.7K | 16 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4236 | Carepatch, per square centimeter | 2.1K | $2.2M | $1.0K | 1.43x |
| Q4217 | Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter | 1.4K | $1.2M | $854.14 | 1.28x |
| Q4205 | Membrane graft or membrane wrap, per square centimeter | 894 | $1.0M | $1.1K | 1.28x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 3.4K | $199.1K | $58.19 | 2.01x |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 555 | $77.3K | $139.33 | 3.15x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1.6K | $58.9K | $36.72 | 2.12x |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 875 | $57.3K | $65.51 | 3.30x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 381 | $35.4K | $92.98 | 2.42x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 216 | $28.3K | $130.89 | 1.72x |
| 87502 | Detection test by nucleic acid for multiple types influenza virus | 266 | $26.4K | $99.43 | 2.07x |
| 96372 | Injection of drug or substance under skin or into muscle | 2.3K | $26.2K | $11.25 | 3.11x |
| 11046 | Removal of muscle and/or tissue, each additional 20.0 sq cm or less | 344 | $15.3K | $44.52 | 2.92x |
| 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 | 182 | $15.1K | $82.87 | 5.27x |
| J0702 | Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg | 2.5K | $10.7K | $4.22 | 2.34x |
| 15275 | Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less | 111 | $10.1K | $90.79 | 5.64x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 994 | $9.6K | $9.64 | 3.06x |
| 99202 | New patient outpatient visit, total time 15-29 minutes | 262 | $9.0K | $34.47 | 2.52x |
| G0008 | Administration of influenza virus vaccine | 360 | $7.0K | $19.44 | 1.80x |
| 90670 | Pneumococcal vaccine for injection into muscle | 31 | $6.1K | $196.00 | 1.02x |
| 36415 | Insertion of needle into vein for collection of blood sample | 2.0K | $5.9K | $2.92 | 3.08x |
This provider submits charges 1.52 times higher than what Medicare actually pays.
A markup ratio of 1.52x means for every $100 Medicare pays, this provider initially charges $152. 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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