This provider's $4.5M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 319% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 178% in 2019
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 | $98.19 | $59.52 | 1.65x | $38.67 | $188.9K | 3.4K | 1.7K |
| 2015 | $94.48 | $52.52 | 1.80x | $41.96 | $158.0K | 2.1K | 979 |
| 2016 | $141.45 | $86.18 | 1.64x | $55.27 | $164.4K | 2.2K | 911 |
| 2017 | $113.00 | $52.54 | 2.15x | $60.46 | $104.9K | 1.7K | 713 |
| 2018 | $129.84 | $46.63 | 2.78x | $83.21 | $129.3K | 1.9K | 982 |
| 2019 | $146.10 | $68.44 | 2.13x | $77.66 | $359.7K | 6.6K | 2.9K |
| 2020 | $110.57 | $55.83 | 1.98x | $54.74 | $675.2K | 13.4K | 5.1K |
| 2021 | $96.22 | $53.98 | 1.78x | $42.24 | $1.0M | 18.8K | 6.1K |
| 2022 | $113.75 | $64.51 | 1.76x | $49.24 | $911.3K | 16.1K | 4.4K |
| 2023 | $123.09 | $65.34 | 1.88x | $57.75 | $791.1K | 13.1K | 3.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 21.1K | $1.6M | $74.55 | 1.99x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 13.4K | $1.2M | $88.63 | 2.08x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 14.6K | $559.5K | $38.24 | 1.51x |
| 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 | 5.3K | $233.3K | $44.11 | 3.38x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 3.9K | $210.7K | $53.78 | 1.86x |
| 99483 | Assessment of and care planning for patient with impaired thought processing, typically 50 minutes | 570 | $137.1K | $240.56 | 1.59x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 879 | $111.0K | $126.28 | 2.53x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 577 | $78.9K | $136.71 | 1.28x |
| 99441 | Physician telephone patient service, 5-10 minutes of medical discussion | 1.4K | $69.4K | $48.61 | 1.54x |
| 99491 | Chronic care management services by qualified health care professional, 30 minutes or more per calendar month | 804 | $46.7K | $58.02 | 1.72x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 2.8K | $40.5K | $14.67 | 2.67x |
| G0008 | Administration of influenza virus vaccine | 1.0K | $28.2K | $27.44 | 1.49x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 1.8K | $24.0K | $13.53 | 3.41x |
| 99349 | Established patient home visit, typically 40 minutes | 203 | $21.7K | $107.13 | 1.68x |
| 90694 | Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | 242 | $18.3K | $75.81 | 1.33x |
| 36410 | Insertion of needle into vein, patient 3 years or older | 1.1K | $16.0K | $14.95 | 2.00x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 176 | $13.4K | $76.22 | 2.19x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 242 | $12.1K | $49.88 | 1.81x |
| 99495 | Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge | 74 | $11.9K | $160.87 | 1.88x |
| G0444 | Annual depression screening, 15 minutes | 462 | $9.6K | $20.88 | 1.67x |
This provider submits charges 2.02 times higher than what Medicare actually pays.
A markup ratio of 2.02x means for every $100 Medicare pays, this provider initially charges $202. 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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