This provider's $3.9M in total Medicare payments ranks in the 99th percentile of Internal Medicine 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 | $66.73 | $36.69 | 1.82x | $30.04 | $332.3K | 10.1K | 6.1K |
| 2015 | $67.94 | $37.72 | 1.80x | $30.22 | $335.0K | 10.2K | 6.1K |
| 2016 | $67.94 | $36.85 | 1.84x | $31.09 | $325.8K | 9.9K | 6.0K |
| 2017 | $77.07 | $41.15 | 1.87x | $35.92 | $333.7K | 9.1K | 5.9K |
| 2018 | $74.90 | $39.87 | 1.88x | $35.03 | $345.8K | 9.1K | 5.9K |
| 2019 | $73.25 | $40.47 | 1.81x | $32.78 | $378.5K | 9.2K | 5.9K |
| 2020 | $80.27 | $45.25 | 1.77x | $35.02 | $499.5K | 10.6K | 5.9K |
| 2021 | $93.09 | $56.47 | 1.65x | $36.62 | $488.9K | 9.9K | 6.4K |
| 2022 | $98.87 | $58.21 | 1.70x | $40.66 | $445.4K | 9.0K | 5.8K |
| 2023 | $93.30 | $52.41 | 1.78x | $40.89 | $448.2K | 8.0K | 5.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 16.2K | $1.4M | $89.27 | 1.52x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 5.1K | $616.3K | $120.84 | 1.73x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.5K | $412.5K | $63.07 | 1.56x |
| 93923 | Ultrasound study of arteries of both arms and legs | 2.1K | $270.9K | $126.41 | 1.34x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 5.0K | $219.1K | $43.80 | 1.51x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 13.1K | $214.0K | $16.31 | 2.49x |
| 93922 | Ultrasound study of arteries of both arms and legs | 1.8K | $141.1K | $79.79 | 1.44x |
| 94750 | Measurement of lung stretching capacity | 2.7K | $138.1K | $51.05 | 1.28x |
| 94010 | Measurement and graphic recording of total and timed exhaled air capacity | 4.1K | $125.4K | $30.49 | 1.64x |
| 92552 | Pure tone air conduction threshold hearing assessment | 3.2K | $97.3K | $30.22 | 1.35x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 5.0K | $65.1K | $13.06 | 4.44x |
| 77081 | Bone density measurement using dedicated X-ray machine | 1.1K | $38.8K | $34.29 | 2.33x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 245 | $30.6K | $125.06 | 1.53x |
| 81003 | Automated urinalysis test | 10.8K | $28.6K | $2.64 | 8.33x |
| 85651 | Red blood cell sedimentation rate, to detect inflammation | 4.9K | $22.2K | $4.49 | 8.04x |
| 82272 | Stool analysis for blood | 3.9K | $16.1K | $4.17 | 6.71x |
| 36415 | Insertion of needle into vein for collection of blood sample | 5.4K | $16.0K | $2.94 | 1.70x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 93 | $15.2K | $163.20 | 1.60x |
| 82570 | Creatinine level to test for kidney function or muscle injury | 1.3K | $8.0K | $6.05 | 6.78x |
| 82044 | Urine microalbumin (protein) analysis | 1.3K | $6.6K | $4.98 | 3.01x |
This provider submits charges 1.77 times higher than what Medicare actually pays.
A markup ratio of 1.77x means for every $100 Medicare pays, this provider initially charges $177. 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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