This provider's $5.1M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 2253% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1592% in 2023
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 | $126.30 | $72.65 | 1.74x | $53.65 | $124.9K | 1.7K | 18 |
| 2015 | $107.84 | $65.66 | 1.64x | $42.18 | $226.5K | 3.5K | 15 |
| 2016 | $107.08 | $68.71 | 1.56x | $38.37 | $208.8K | 3.0K | 18 |
| 2017 | $116.28 | $79.49 | 1.46x | $36.79 | $153.0K | 1.9K | 14 |
| 2018 | $282.08 | $100.05 | 2.82x | $182.03 | $394.4K | 3.9K | 16 |
| 2019 | $271.92 | $101.04 | 2.69x | $170.88 | $353.7K | 3.5K | 12 |
| 2020 | $239.35 | $101.04 | 2.37x | $138.31 | $321.6K | 3.2K | 14 |
| 2021 | $174.22 | $91.94 | 1.89x | $82.28 | $220.3K | 2.4K | 13 |
| 2022 | $220.81 | $97.05 | 2.28x | $123.76 | $173.7K | 1.8K | 10 |
| 2023 | $998.45 | $759.76 | 1.31x | $238.69 | $2.9M | 3.9K | 9 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4217 | Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter | 2.8K | $2.8M | $999.07 | 1.29x |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 2.8K | $386.5K | $137.63 | 1.78x |
| Q4186 | Epifix, per square centimeter | 2.2K | $280.5K | $126.39 | 3.96x |
| 99349 | Established patient home visit, typically 40 minutes | 2.8K | $275.4K | $99.47 | 1.45x |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 4.6K | $264.5K | $57.19 | 1.71x |
| Q4131 | Epifix or epicord, per square centimeter | 1.6K | $205.8K | $125.57 | 3.98x |
| 99308 | Follow-up nursing facility visit per day, typically 15 minutes | 1.9K | $101.2K | $53.49 | 1.60x |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 868 | $93.4K | $107.57 | 1.66x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 912 | $92.8K | $101.70 | 1.40x |
| 15271 | Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less | 784 | $81.7K | $104.16 | 2.31x |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 587 | $76.5K | $130.33 | 1.96x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 764 | $54.1K | $70.76 | 1.56x |
| 99305 | Initial nursing facility visit per day, typically 35 minutes | 522 | $52.9K | $101.43 | 1.72x |
| 99348 | Established patient home visit, typically 25 minutes | 811 | $52.5K | $64.73 | 1.65x |
| 99344 | Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes | 281 | $37.6K | $133.85 | 1.64x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 368 | $30.4K | $82.48 | 1.45x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 183 | $21.1K | $115.13 | 1.43x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 280 | $20.7K | $73.99 | 1.49x |
| 97605 | Therapy procedure using a special bandage and vacuum pump, surface area 50.0 sq cm or less | 913 | $19.1K | $20.91 | 2.15x |
| 99183 | Management and supervision of oxygen chamber therapy per session | 169 | $16.4K | $97.18 | 1.75x |
This provider submits charges 1.69 times higher than what Medicare actually pays.
A markup ratio of 1.69x means for every $100 Medicare pays, this provider initially charges $169. 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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