This provider's $4.9M in total Medicare payments ranks in the 99th percentile of Mass Immunizer Roster Biller providers nationally.
Medicare payments to this provider grew 170423% from 2020 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 25340% in 2021
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 |
|---|---|---|---|---|---|---|---|
| 2020 | $46.72 | $37.23 | 1.25x | $9.49 | $1.4K | 37 | 37 |
| 2021 | $46.48 | $38.02 | 1.22x | $8.46 | $344.3K | 9.4K | 9.4K |
| 2022 | $92.76 | $57.04 | 1.63x | $35.72 | $2.2M | 50.0K | 41.0K |
| 2023 | $100.74 | $69.54 | 1.45x | $31.20 | $2.3M | 35.8K | 27.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 0241U | Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected | 8.7K | $1.2M | $139.95 | 2.04x |
| M0201 | Covid-19 vaccine administration inside a patient's home; reported only once per individual home per date of service when only covid-19 vaccine administration is performed at the patient's home | 13.5K | $446.9K | $33.21 | 1.09x |
| 90694 | Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, for injection into muscle, 0.5 ml dosage | 5.3K | $383.0K | $72.45 | 1.15x |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 2.6K | $375.7K | $143.00 | 1.05x |
| 87811 | Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) | 7.7K | $314.5K | $40.63 | 2.04x |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 11.6K | $267.3K | $23.02 | 1.53x |
| 0064A | Fee covid-19 vac 7 res | 6.4K | $236.0K | $37.12 | 1.10x |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r | 2.8K | $204.5K | $73.92 | 2.03x |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 1.3K | $168.6K | $128.48 | 1.06x |
| G0008 | Administration of influenza virus vaccine | 5.8K | $155.9K | $26.79 | 1.02x |
| 0134A | Fee covid-19 vac 14 res | 4.1K | $150.4K | $36.71 | 1.05x |
| 87637 | Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19), influenza virus types a and b, and respiratory syncytial virus | 1.1K | $149.0K | $132.44 | 2.15x |
| 90480 | Admn sarscov2 vacc 1 dose | 3.8K | $148.3K | $38.57 | 1.02x |
| 0004A | Fee covid-19 vac 1 res | 2.6K | $96.6K | $37.30 | 1.18x |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 321 | $90.4K | $281.71 | 1.33x |
| 0124A | Fee covid-19 vac 13 res | 2.3K | $83.9K | $36.75 | 1.14x |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within | 2.7K | $66.8K | $24.65 | 1.52x |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 3.8K | $61.1K | $16.28 | 2.03x |
| 87636 | Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19) and influenza virus types a and b | 331 | $43.7K | $131.88 | 2.65x |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | 1.0K | $35.4K | $34.68 | 2.04x |
This provider submits charges 1.53 times higher than what Medicare actually pays.
A markup ratio of 1.53x means for every $100 Medicare pays, this provider initially charges $153. 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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