This provider averages 63 services per working day
Based on 157.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $8.3M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Averaging 63 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 73% from 2014 to 2023.
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 | $202.43 | $69.52 | 2.91x | $132.91 | $498.8K | 9.2K | 4.8K |
| 2015 | $200.44 | $69.12 | 2.90x | $131.32 | $552.6K | 9.2K | 4.8K |
| 2016 | $201.33 | $68.75 | 2.93x | $132.58 | $603.2K | 10.5K | 5.4K |
| 2017 | $186.85 | $74.69 | 2.50x | $112.16 | $726.3K | 12.7K | 6.7K |
| 2018 | $197.00 | $69.69 | 2.83x | $127.31 | $1.0M | 18.6K | 10.5K |
| 2019 | $172.02 | $60.53 | 2.84x | $111.49 | $781.0K | 15.4K | 8.4K |
| 2020 | $167.93 | $59.68 | 2.81x | $108.25 | $951.6K | 17.8K | 8.1K |
| 2021 | $137.64 | $52.00 | 2.65x | $85.64 | $1.2M | 23.8K | 9.8K |
| 2022 | $89.43 | $52.96 | 1.69x | $36.47 | $1.1M | 22.8K | 8.5K |
| 2023 | $79.12 | $56.46 | 1.40x | $22.66 | $865.1K | 17.7K | 6.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 28.0K | $2.3M | $83.57 | 2.00x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 14.9K | $541.2K | $36.44 | 2.16x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 4.2K | $462.2K | $110.44 | 2.08x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.6K | $460.7K | $60.95 | 1.73x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 2.4K | $285.8K | $119.37 | 1.81x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 842 | $156.0K | $185.28 | 1.87x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 1.1K | $149.5K | $138.80 | 2.53x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.8K | $144.6K | $80.89 | 2.56x |
| 99483 | Assessment of and care planning for patient with impaired thought processing, typically 50 minutes | 701 | $142.5K | $203.30 | 2.52x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 3.3K | $141.5K | $42.35 | 2.86x |
| 99457 | Remote monitoring of physiologic parameters management services, 20 minutes or more of qualified health care professional time per calendar month | 3.7K | $138.3K | $37.65 | 2.41x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 868 | $132.5K | $152.63 | 2.44x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 1.6K | $122.1K | $78.59 | 7.09x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 1.7K | $117.9K | $69.88 | 1.37x |
| 99493 | Subsequent psychiatric collaborative care management, first 60 minutes in subsequent month of behavioral health care manager activities | 973 | $107.2K | $110.15 | 1.71x |
| 93923 | Ultrasound study of arteries of both arms and legs | 970 | $97.4K | $100.45 | 2.34x |
| 90670 | Pneumococcal vaccine for injection into muscle | 549 | $92.0K | $167.52 | 1.66x |
| 95250 | Ambulatory continuous glucose (sugar) monitoring for a minimum of 72 hours | 738 | $85.0K | $115.14 | 2.42x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 5.5K | $83.3K | $15.13 | 2.98x |
| 93970 | Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers | 584 | $81.4K | $139.34 | 2.43x |
This provider submits charges 2.27 times higher than what Medicare actually pays.
A markup ratio of 2.27x means for every $100 Medicare pays, this provider initially charges $227. 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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