This provider's $3.3M in total Medicare payments ranks in the 97th percentile of Nephrology providers nationally.
Medicare payments to this provider grew 7739% from 2015 to 2023.
62% of their billing comes from a single procedure code (99232 — Subsequent hospital inpatient care, typically 25 minutes per day).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 397% in 2016
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 | $238.40 | $99.26 | 2.40x | $139.14 | $10.8K | 128 | 86 |
| 2016 | $196.70 | $72.55 | 2.71x | $124.15 | $53.8K | 875 | 511 |
| 2017 | $191.00 | $63.13 | 3.03x | $127.87 | $158.9K | 2.4K | 979 |
| 2018 | $303.00 | $126.11 | 2.40x | $176.89 | $245.7K | 2.9K | 1.5K |
| 2019 | $303.40 | $117.30 | 2.59x | $186.10 | $506.2K | 6.9K | 2.1K |
| 2020 | $324.85 | $122.74 | 2.65x | $202.11 | $463.8K | 6.7K | 1.7K |
| 2021 | $360.83 | $137.17 | 2.63x | $223.66 | $505.1K | 7.3K | 1.7K |
| 2022 | $361.25 | $132.08 | 2.74x | $229.17 | $512.9K | 7.5K | 1.7K |
| 2023 | $352.77 | $133.39 | 2.64x | $219.38 | $849.1K | 11.4K | 2.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 35.0K | $2.1M | $58.92 | 2.50x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 4.5K | $478.6K | $107.28 | 2.56x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.3K | $180.1K | $77.30 | 3.03x |
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 622 | $157.7K | $253.48 | 2.55x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 729 | $155.1K | $212.73 | 2.60x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 616 | $73.3K | $119.07 | 2.79x |
| 90937 | Hemodialysis procedure with repeated evaluations | 704 | $58.4K | $82.89 | 2.55x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 346 | $52.2K | $150.73 | 2.61x |
| 90935 | Hemodialysis procedure with one physician evaluation | 379 | $23.5K | $62.02 | 2.39x |
| 90947 | Dialysis procedure requiring repeat evaluation | 186 | $18.3K | $98.47 | 2.56x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 96 | $15.0K | $156.43 | 2.59x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 319 | $9.9K | $31.15 | 2.54x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 169 | $8.6K | $50.94 | 2.86x |
| 90945 | Dialysis procedure including one evaluation | 71 | $5.0K | $70.72 | 2.46x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 65 | $4.6K | $70.93 | 2.59x |
| 99219 | Hospital observation care, typically 50 minutes | 12 | $1.3K | $110.27 | 2.50x |
This provider submits charges 2.56 times higher than what Medicare actually pays.
A markup ratio of 2.56x means for every $100 Medicare pays, this provider initially charges $256. 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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