This provider's $4.4M in total Medicare payments ranks in the 99th percentile of Pediatric Medicine providers nationally.
Medicare payments to this provider grew 1606% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 483% 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 |
|---|---|---|---|---|---|---|---|
| 2014 | $78.67 | $29.68 | 2.65x | $48.99 | $35.6K | 1.1K | 810 |
| 2015 | $102.06 | $38.04 | 2.68x | $64.02 | $70.2K | 1.7K | 1.3K |
| 2016 | $315.82 | $78.72 | 4.01x | $237.10 | $409.1K | 6.3K | 5.6K |
| 2017 | $367.12 | $93.32 | 3.93x | $273.80 | $406.3K | 4.9K | 4.5K |
| 2018 | $372.75 | $93.62 | 3.98x | $279.13 | $433.4K | 5.1K | 4.8K |
| 2019 | $358.73 | $92.90 | 3.86x | $265.83 | $572.8K | 6.6K | 6.2K |
| 2020 | $365.81 | $95.55 | 3.83x | $270.26 | $607.1K | 7.1K | 6.7K |
| 2021 | $379.38 | $94.57 | 4.01x | $284.81 | $703.5K | 8.0K | 7.4K |
| 2022 | $352.49 | $89.32 | 3.95x | $263.17 | $601.5K | 7.3K | 6.7K |
| 2023 | $372.09 | $90.79 | 4.10x | $281.30 | $607.3K | 7.6K | 7.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 77067 | Mammography of both breasts | 4.5K | $560.2K | $123.75 | 2.10x |
| 74177 | CT scan of abdomen and pelvis with contrast | 1.6K | $344.4K | $221.19 | 3.61x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.4K | $234.4K | $68.49 | 2.85x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 686 | $227.9K | $332.23 | 2.70x |
| 72148 | MRI scan of lower spinal canal | 1.4K | $197.0K | $144.97 | 5.70x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 1.4K | $194.4K | $141.90 | 3.70x |
| G0202 | Screening mammography, producing direct digital image, bilateral, all views | 1.4K | $169.1K | $122.18 | 2.01x |
| 74183 | MRI scan of abdomen before and after contrast | 418 | $114.3K | $273.41 | 5.94x |
| 77080 | Bone density measurement using dedicated X-ray machine | 3.0K | $110.3K | $36.28 | 4.74x |
| 77063 | Screening digital tomography of both breasts | 2.1K | $106.0K | $50.85 | 2.05x |
| 70553 | MRI scan of brain before and after contrast | 419 | $105.5K | $251.69 | 6.07x |
| 74176 | CT scan of abdomen and pelvis | 759 | $103.6K | $136.50 | 3.42x |
| 74178 | CT scan of abdomen and pelvis before and after contrast | 397 | $103.5K | $260.71 | 4.30x |
| 71250 | CT scan chest | 971 | $97.1K | $100.04 | 5.00x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 638 | $84.3K | $132.15 | 3.53x |
| 71260 | CT scan chest with contrast | 686 | $84.1K | $122.61 | 4.49x |
| 78306 | Bone and/or joint imaging, whole body | 374 | $79.7K | $213.18 | 2.24x |
| 72141 | MRI scan of upper spinal canal | 541 | $78.3K | $144.64 | 5.74x |
| 72158 | MRI scan of lower spinal canal before and after contrast | 309 | $77.5K | $250.79 | 6.28x |
| 73721 | MRI scan of leg joint | 486 | $74.9K | $154.08 | 5.74x |
This provider submits charges 3.62 times higher than what Medicare actually pays.
A markup ratio of 3.62x means for every $100 Medicare pays, this provider initially charges $362. 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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