This provider's $7.2M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 70% 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 | $120.96 | $60.46 | 2.00x | $60.50 | $465.5K | 7.6K | 4.6K |
| 2015 | $116.26 | $58.27 | 2.00x | $57.99 | $645.4K | 10.0K | 5.7K |
| 2016 | $101.66 | $49.57 | 2.05x | $52.09 | $630.9K | 11.6K | 7.2K |
| 2017 | $97.79 | $49.97 | 1.96x | $47.82 | $668.6K | 12.9K | 8.2K |
| 2018 | $100.91 | $52.43 | 1.92x | $48.48 | $709.1K | 13.2K | 8.2K |
| 2019 | $106.20 | $55.33 | 1.92x | $50.87 | $744.8K | 12.8K | 7.6K |
| 2020 | $120.64 | $66.18 | 1.82x | $54.46 | $758.0K | 12.3K | 7.8K |
| 2021 | $131.27 | $65.60 | 2.00x | $65.67 | $890.2K | 12.4K | 7.9K |
| 2022 | $131.99 | $64.65 | 2.04x | $67.34 | $881.0K | 12.3K | 7.6K |
| 2023 | $126.97 | $62.08 | 2.05x | $64.89 | $790.3K | 10.0K | 5.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 32.6K | $2.6M | $81.01 | 2.07x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 10.2K | $1.2M | $119.24 | 2.50x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 17.8K | $904.3K | $50.88 | 2.20x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 7.5K | $422.5K | $56.61 | 1.92x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 1.6K | $296.2K | $190.58 | 1.89x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.8K | $181.3K | $99.45 | 2.58x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.2K | $147.2K | $122.36 | 1.91x |
| G0444 | Annual depression screening, 15 minutes | 7.3K | $131.4K | $17.90 | 1.64x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 923 | $96.4K | $104.41 | 1.48x |
| 99495 | Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge | 710 | $95.2K | $134.05 | 1.90x |
| 99238 | Hospital discharge day management, 30 minutes or less | 1.4K | $79.9K | $57.19 | 1.93x |
| G0442 | Annual alcohol misuse screening, 15 minutes | 4.1K | $73.1K | $17.90 | 1.60x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 480 | $72.8K | $151.61 | 1.85x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 384 | $64.6K | $168.22 | 1.48x |
| 90732 | Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older | 660 | $63.6K | $96.32 | 1.59x |
| 92552 | Pure tone air conduction threshold hearing assessment | 3.0K | $61.5K | $20.66 | 2.85x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 718 | $59.5K | $82.89 | 1.42x |
| 99443 | Physician telephone patient service, 21-30 minutes of medical discussion | 647 | $55.7K | $86.07 | 1.97x |
| G0008 | Administration of influenza virus vaccine | 2.1K | $46.8K | $21.97 | 1.67x |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 271 | $44.0K | $162.44 | 1.68x |
This provider submits charges 2.13 times higher than what Medicare actually pays.
A markup ratio of 2.13x means for every $100 Medicare pays, this provider initially charges $213. 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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