This provider's $4.4M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner 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 | $130.39 | $67.58 | 1.93x | $62.81 | $555.5K | 9.0K | 3.6K |
| 2015 | $130.37 | $68.87 | 1.89x | $61.50 | $430.5K | 7.7K | 3.1K |
| 2016 | $137.44 | $73.77 | 1.86x | $63.67 | $369.6K | 6.6K | 2.7K |
| 2017 | $146.09 | $76.36 | 1.91x | $69.73 | $387.2K | 6.9K | 2.8K |
| 2018 | $132.63 | $67.36 | 1.97x | $65.27 | $428.3K | 8.2K | 3.0K |
| 2019 | $134.42 | $68.09 | 1.97x | $66.33 | $384.1K | 7.0K | 2.5K |
| 2020 | $153.16 | $76.06 | 2.01x | $77.10 | $408.8K | 7.4K | 2.4K |
| 2021 | $150.96 | $75.49 | 2.00x | $75.47 | $477.1K | 8.7K | 2.4K |
| 2022 | $158.27 | $75.30 | 2.10x | $82.97 | $482.1K | 9.1K | 2.3K |
| 2023 | $153.54 | $74.84 | 2.05x | $78.70 | $476.4K | 8.7K | 2.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90833 | Psychotherapy, 30 minutes with patient and/or family member | 26.7K | $1.2M | $45.47 | 1.85x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 15.5K | $775.2K | $50.16 | 1.54x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 8.3K | $532.7K | $63.99 | 1.88x |
| 90792 | Psychiatric diagnostic evaluation with medical services | 2.9K | $291.4K | $100.26 | 2.36x |
| 99334 | Established patient assisted living visit, typically 15 minutes | 6.3K | $266.2K | $42.34 | 1.77x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 1.9K | $223.9K | $119.40 | 1.68x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.4K | $175.9K | $74.00 | 1.69x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.9K | $136.3K | $73.61 | 2.62x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 4.0K | $124.3K | $30.79 | 1.62x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 736 | $105.1K | $142.78 | 1.84x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.9K | $98.7K | $51.91 | 2.01x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 990 | $90.4K | $91.30 | 1.84x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 1.1K | $72.0K | $66.36 | 1.51x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 676 | $63.9K | $94.57 | 2.28x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.1K | $63.2K | $57.15 | 2.79x |
| 90836 | Psychotherapy, 45 minutes with patient and/or family member | 537 | $31.8K | $59.28 | 1.76x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 324 | $31.3K | $96.62 | 2.60x |
| 99328 | New patient assisted living visit, typically 75 minutes | 166 | $24.7K | $148.83 | 1.73x |
| 99347 | Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes | 686 | $21.8K | $31.77 | 2.36x |
| 99356 | Prolonged inpatient or observation hospital service first hour | 252 | $16.4K | $64.90 | 1.85x |
This provider submits charges 1.86 times higher than what Medicare actually pays.
A markup ratio of 1.86x means for every $100 Medicare pays, this provider initially charges $186. 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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