This provider's $5.3M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Medicare payments to this provider grew 8555% from 2015 to 2023.
98% of their billing comes from a single procedure code (Q4236 — Carepatch, per square centimeter).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 25559% 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 |
|---|---|---|---|---|---|---|---|
| 2015 | $242.34 | $65.36 | 3.71x | $176.98 | $60.7K | 928 | 6 |
| 2016 | $208.00 | $44.63 | 4.66x | $163.37 | $892.52 | 20 | 1 |
| 2020 | $311.76 | $107.20 | 2.91x | $204.56 | $7.4K | 69 | 3 |
| 2021 | $264.48 | $85.60 | 3.09x | $178.88 | $20.5K | 239 | 5 |
| 2023 | $1.3K | $960.42 | 1.40x | $382.26 | $5.2M | 5.5K | 6 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4236 | Carepatch, per square centimeter | 5.2K | $5.2M | $1.0K | 1.39x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 544 | $32.0K | $58.81 | 3.54x |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 160 | $17.6K | $110.18 | 3.31x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 140 | $12.1K | $86.34 | 3.57x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 133 | $10.0K | $75.28 | 4.01x |
| 99497 | Advance care planning, first 30 minutes | 173 | $9.5K | $54.93 | 3.17x |
| 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 | 85 | $9.1K | $107.40 | 1.73x |
| 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 | 58 | $5.9K | $101.15 | 2.16x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 29 | $5.4K | $185.34 | 2.73x |
| 99344 | New patient home visit, typically 60 minutes | 37 | $4.3K | $115.60 | 3.26x |
| 99443 | Telephone medical discussion with physician, 21-30 minutes | 52 | $3.6K | $68.99 | 2.06x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 43 | $2.8K | $66.02 | 5.80x |
| 99345 | Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes | 20 | $2.7K | $135.88 | 3.24x |
| 99304 | Initial nursing facility visit, typically 25 minutes per day | 44 | $2.6K | $59.94 | 3.49x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 44 | $2.0K | $44.89 | 3.52x |
This provider submits charges 1.43 times higher than what Medicare actually pays.
A markup ratio of 1.43x means for every $100 Medicare pays, this provider initially charges $143. 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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