This provider averages 134 services per working day
Based on 334.2K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $16.6M in total Medicare payments ranks in the 99th percentile of Infectious Disease providers nationally.
Their average markup ratio of 5.2x is significantly above the specialty median of 2.8x.
Averaging 134 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 536% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 167% in 2019
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 |
|---|---|---|---|---|---|---|---|
| 2014 | $179.36 | $34.42 | 5.21x | $144.94 | $495.1K | 14.4K | 15 |
| 2015 | $165.63 | $32.63 | 5.08x | $133.00 | $629.3K | 19.3K | 16 |
| 2016 | $166.81 | $35.97 | 4.64x | $130.84 | $595.2K | 16.5K | 11 |
| 2017 | $162.23 | $31.67 | 5.12x | $130.56 | $861.4K | 27.2K | 12 |
| 2018 | $160.83 | $32.94 | 4.88x | $127.89 | $1.2M | 36.9K | 15 |
| 2019 | $273.18 | $64.22 | 4.25x | $208.96 | $3.2M | 50.5K | 20 |
| 2020 | $333.21 | $65.77 | 5.07x | $267.44 | $2.5M | 37.6K | 18 |
| 2021 | $265.03 | $46.50 | 5.70x | $218.53 | $2.0M | 42.3K | 17 |
| 2022 | $360.56 | $67.02 | 5.38x | $293.54 | $1.9M | 29.0K | 15 |
| 2023 | $320.43 | $52.12 | 6.15x | $268.31 | $3.1M | 60.4K | 15 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J1599 | Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mg | 74.4K | $6.4M | $86.53 | 5.09x |
| J1561 | Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg | 82.1K | $3.1M | $37.99 | 7.15x |
| J1566 | Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg | 105.8K | $2.9M | $27.42 | 5.88x |
| J1556 | Injection, immune globulin (bivigam), 500 mg | 28.1K | $1.6M | $55.86 | 4.33x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 7.7K | $576.5K | $74.81 | 2.86x |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 8.1K | $447.2K | $55.20 | 2.62x |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 2.9K | $443.6K | $150.85 | 2.68x |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 4.4K | $354.5K | $80.87 | 2.56x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 3.7K | $196.6K | $52.56 | 3.11x |
| 96366 | Infusion into a vein for therapy, prevention, or diagnosis, each additional hour | 10.0K | $160.0K | $16.04 | 4.56x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 872 | $97.2K | $111.48 | 2.53x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 650 | $75.3K | $115.87 | 2.85x |
| 99213 | Established patient outpatient visit, total time 20-29 minutes | 1.1K | $58.5K | $53.50 | 2.65x |
| 36589 | Removal of central venous catheter for infusion | 232 | $27.7K | $119.26 | 2.71x |
| G0181 | Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow | 240 | $19.3K | $80.46 | 2.70x |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 158 | $16.2K | $102.74 | 2.61x |
| G0180 | Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and | 408 | $16.1K | $39.40 | 2.65x |
| 96375 | Injection of additional new drug or substance into vein | 1.3K | $16.1K | $12.66 | 9.24x |
| 99443 | Telephone medical discussion with physician, 21-30 minutes | 108 | $10.1K | $93.23 | 2.31x |
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 323 | $10.0K | $30.89 | 2.52x |
This provider submits charges 5.2 times higher than what Medicare actually pays.
A markup ratio of 5.2x means for every $100 Medicare pays, this provider initially charges $520. 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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