This provider's $4.6M in total Medicare payments ranks in the 99th percentile of Critical Care (Intensivists) 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 | $379.25 | $90.32 | 4.20x | $288.93 | $414.5K | 3.4K | 1.7K |
| 2015 | $582.82 | $141.30 | 4.12x | $441.52 | $507.6K | 3.6K | 2.0K |
| 2016 | $467.43 | $131.25 | 3.56x | $336.18 | $517.8K | 3.7K | 2.1K |
| 2017 | $431.91 | $123.41 | 3.50x | $308.50 | $581.9K | 4.3K | 2.4K |
| 2018 | $492.28 | $131.56 | 3.74x | $360.72 | $536.9K | 4.2K | 2.4K |
| 2019 | $561.47 | $133.16 | 4.22x | $428.31 | $488.3K | 4.0K | 2.4K |
| 2020 | $593.40 | $137.71 | 4.31x | $455.69 | $354.0K | 3.2K | 1.7K |
| 2021 | $552.16 | $123.40 | 4.47x | $428.76 | $364.2K | 3.5K | 1.9K |
| 2022 | $539.46 | $123.32 | 4.37x | $416.14 | $402.9K | 3.7K | 2.2K |
| 2023 | $488.16 | $123.43 | 3.95x | $364.73 | $428.8K | 3.7K | 2.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 7.2K | $1.4M | $188.85 | 2.29x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 10.0K | $620.3K | $62.21 | 2.25x |
| 95810 | Sleep monitoring of patient (6 years or older) in sleep lab | 1.0K | $476.7K | $474.37 | 5.45x |
| 95811 | Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube | 959 | $475.5K | $495.87 | 6.68x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 4.7K | $432.5K | $92.62 | 2.35x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.8K | $262.9K | $94.18 | 1.95x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.3K | $221.5K | $168.07 | 1.81x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.2K | $141.0K | $122.41 | 2.41x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.8K | $116.3K | $64.02 | 2.11x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 832 | $114.4K | $137.52 | 1.78x |
| 99443 | Physician telephone patient service, 21-30 minutes of medical discussion | 793 | $86.3K | $108.80 | 1.60x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 563 | $65.4K | $116.18 | 1.98x |
| 36556 | Insertion of central venous catheter for infusion, patient 5 years or older | 353 | $31.3K | $88.56 | 2.81x |
| 94060 | Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration | 679 | $27.3K | $40.24 | 4.07x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 124 | $21.6K | $174.13 | 2.68x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 559 | $21.1K | $37.71 | 2.80x |
| 94729 | Measurement of lung diffusing capacity | 488 | $20.3K | $41.55 | 2.82x |
| 99183 | Management and supervision of oxygen chamber therapy per session | 178 | $17.0K | $95.76 | 3.02x |
| 94727 | Determination of lung volumes using gas dilution or washout | 489 | $15.9K | $32.61 | 2.63x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 167 | $15.8K | $94.34 | 1.84x |
This provider submits charges 3.04 times higher than what Medicare actually pays.
A markup ratio of 3.04x means for every $100 Medicare pays, this provider initially charges $304. 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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