This provider's $6.4M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 114% in 2020
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 | $143.15 | $100.13 | 1.43x | $43.02 | $387.5K | 4.1K | 2.7K |
| 2015 | $503.58 | $94.85 | 5.31x | $408.73 | $326.5K | 3.4K | 2.4K |
| 2016 | $543.36 | $89.32 | 6.08x | $454.04 | $442.5K | 4.7K | 3.2K |
| 2017 | $600.47 | $95.48 | 6.29x | $504.99 | $516.3K | 5.6K | 3.6K |
| 2018 | $652.37 | $97.08 | 6.72x | $555.29 | $399.5K | 4.2K | 3.1K |
| 2019 | $502.84 | $89.87 | 5.60x | $412.97 | $361.2K | 3.8K | 2.8K |
| 2020 | $479.01 | $84.43 | 5.67x | $394.58 | $774.2K | 9.5K | 3.2K |
| 2021 | $391.76 | $84.72 | 4.62x | $307.04 | $1.5M | 20.8K | 6.8K |
| 2022 | $378.69 | $82.37 | 4.60x | $296.32 | $1.4M | 20.7K | 8.3K |
| 2023 | $501.10 | $91.05 | 5.50x | $410.05 | $306.7K | 2.7K | 2.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 19.8K | $1.3M | $64.94 | 5.24x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 7.7K | $1.2M | $153.62 | 3.10x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 10.8K | $908.7K | $84.24 | 4.60x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 4.7K | $337.7K | $72.13 | 5.10x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 4.9K | $318.3K | $65.12 | 11.21x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 5.2K | $292.8K | $56.73 | 1.44x |
| 99457 | Remote physiologic monitoring treatment management services, health care professional time in a calendar month requiring interactive communication with the patient/caregiver; first 20 minutes | 5.1K | $244.0K | $47.49 | 1.41x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.5K | $235.9K | $93.50 | 8.33x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 2.6K | $221.5K | $85.13 | 2.94x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 1.6K | $194.7K | $118.79 | 2.87x |
| 99239 | Hospital discharge day management, more than 30 minutes | 1.7K | $162.1K | $96.41 | 7.51x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 1.2K | $146.6K | $118.00 | 2.54x |
| 99316 | Nursing facility discharge management, more than 30 minutes | 1.1K | $111.9K | $97.29 | 4.85x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 561 | $102.3K | $182.33 | 5.52x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 789 | $97.7K | $123.85 | 8.60x |
| G0180 | Physician 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 to affirm the initial imple | 2.0K | $96.7K | $48.90 | 1.89x |
| G0181 | Physician 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 development and/or revision of c | 928 | $92.7K | $99.89 | 2.00x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 367 | $73.4K | $199.93 | 6.46x |
| 99453 | Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment | 2.6K | $49.7K | $18.96 | 1.39x |
| 99424 | Principal care management services for a single high-risk disease, first 30 minutes provided personally by qualified health care professional, per calendar month. | 474 | $33.8K | $71.22 | 1.42x |
This provider submits charges 4.55 times higher than what Medicare actually pays.
A markup ratio of 4.55x means for every $100 Medicare pays, this provider initially charges $455. 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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