This provider's $3.9M in total Medicare payments ranks in the 98th percentile of Nephrology 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 | $200.80 | $69.06 | 2.91x | $131.74 | $441.7K | 6.3K | 1.6K |
| 2015 | $244.53 | $84.10 | 2.91x | $160.43 | $424.6K | 5.8K | 1.6K |
| 2016 | $236.85 | $82.29 | 2.88x | $154.56 | $512.1K | 7.5K | 1.9K |
| 2017 | $255.67 | $86.62 | 2.95x | $169.05 | $481.8K | 6.9K | 1.7K |
| 2018 | $229.08 | $74.56 | 3.07x | $154.52 | $517.4K | 6.2K | 1.7K |
| 2019 | $234.27 | $77.51 | 3.02x | $156.76 | $512.9K | 5.8K | 1.6K |
| 2020 | $227.69 | $75.71 | 3.01x | $151.98 | $310.2K | 3.6K | 1.2K |
| 2021 | $235.62 | $88.98 | 2.65x | $146.64 | $297.1K | 3.6K | 1.3K |
| 2022 | $185.07 | $70.43 | 2.63x | $114.64 | $239.0K | 3.1K | 1.1K |
| 2023 | $133.14 | $56.30 | 2.36x | $76.84 | $162.4K | 2.4K | 887 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 20.8K | $1.1M | $52.78 | 1.77x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 11.7K | $907.4K | $77.82 | 2.25x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 4.8K | $699.0K | $147.04 | 1.93x |
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 2.5K | $535.9K | $212.33 | 3.77x |
| 90935 | Hemodialysis procedure with one physician evaluation | 6.1K | $330.9K | $54.09 | 4.16x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.2K | $119.8K | $96.67 | 2.59x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 365 | $65.7K | $179.94 | 4.17x |
| 90947 | Dialysis procedure requiring repeat evaluation | 518 | $48.5K | $93.54 | 3.97x |
| 99214 | Established patient outpatient visit, total time 30-39 minutes | 301 | $23.5K | $78.02 | 2.31x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 162 | $22.5K | $138.97 | 2.17x |
| 99238 | Hospital discharge day management, 30 minutes or less | 368 | $19.5K | $52.93 | 1.80x |
| 99220 | Hospital observation care typically 70 minutes per day | 118 | $16.1K | $136.18 | 1.78x |
| 82947 | Blood glucose (sugar) level | 913 | $4.1K | $4.46 | 2.24x |
| 83036 | Hemoglobin A1C level | 143 | $1.6K | $11.10 | 2.25x |
| 36415 | Insertion of needle into vein for collection of blood sample | 431 | $1.4K | $3.23 | 3.09x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 11 | $1.2K | $108.40 | 1.89x |
| 85018 | Hemoglobin measurement | 392 | $1.0K | $2.66 | 3.76x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 86 | $942.02 | $10.95 | 4.84x |
| 90674 | Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free | 14 | $461.42 | $32.96 | 1.18x |
| 81003 | Automated urinalysis test | 185 | $446.74 | $2.41 | 4.14x |
This provider submits charges 2.49 times higher than what Medicare actually pays.
A markup ratio of 2.49x means for every $100 Medicare pays, this provider initially charges $249. This is higher 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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