This provider's $4.2M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 840% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 376% in 2017
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 | $279.71 | $100.19 | 2.79x | $179.52 | $107.1K | 1.5K | 680 |
| 2015 | $340.55 | $99.60 | 3.42x | $240.95 | $65.1K | 945 | 527 |
| 2016 | $238.81 | $110.61 | 2.16x | $128.20 | $23.3K | 191 | 135 |
| 2017 | $311.88 | $105.04 | 2.97x | $206.84 | $110.9K | 888 | 715 |
| 2018 | $303.88 | $98.60 | 3.08x | $205.28 | $269.6K | 2.4K | 1.4K |
| 2019 | $271.56 | $103.29 | 2.63x | $168.27 | $522.3K | 4.9K | 2.4K |
| 2020 | $271.31 | $106.53 | 2.55x | $164.78 | $591.6K | 5.8K | 2.6K |
| 2021 | $269.51 | $104.76 | 2.57x | $164.75 | $633.0K | 6.4K | 2.4K |
| 2022 | $284.89 | $111.47 | 2.56x | $173.42 | $874.1K | 9.1K | 3.0K |
| 2023 | $286.00 | $117.97 | 2.42x | $168.03 | $1.0M | 11.4K | 3.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 8.3K | $1.4M | $175.10 | 2.76x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 21.2K | $1.4M | $67.71 | 2.36x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 11.9K | $1.1M | $94.13 | 2.38x |
| 99239 | Hospital discharge day management, more than 30 minutes | 1.3K | $126.3K | $96.75 | 2.86x |
| 99356 | Prolonged inpatient or observation hospital service first hour | 452 | $37.7K | $83.42 | 2.36x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 155 | $18.0K | $116.22 | 3.05x |
| 99310 | Follow-up nursing facility visit per day, typically 35 minutes | 55 | $7.1K | $129.64 | 2.47x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 54 | $4.3K | $79.00 | 3.66x |
| 99306 | Initial nursing facility visit per day, typically 45 minutes | 26 | $3.9K | $151.62 | 2.54x |
| 99358 | Extended patient service without direct patient contact, first hour | 14 | $1.4K | $101.51 | 2.50x |
This provider submits charges 2.52 times higher than what Medicare actually pays.
A markup ratio of 2.52x means for every $100 Medicare pays, this provider initially charges $252. 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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