This provider's $5.0M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 1234% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 149% in 2018
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 | $616.88 | $115.02 | 5.36x | $501.86 | $102.5K | 1.1K | 641 |
| 2015 | $571.64 | $115.75 | 4.94x | $455.89 | $122.5K | 1.3K | 871 |
| 2016 | $443.21 | $100.01 | 4.43x | $343.20 | $107.8K | 1.2K | 812 |
| 2017 | $492.34 | $97.86 | 5.03x | $394.48 | $119.6K | 1.3K | 786 |
| 2018 | $323.39 | $90.54 | 3.57x | $232.85 | $298.1K | 3.9K | 1.1K |
| 2019 | $303.39 | $91.43 | 3.32x | $211.96 | $447.3K | 6.3K | 1.5K |
| 2020 | $250.67 | $88.83 | 2.82x | $161.84 | $618.8K | 8.0K | 1.8K |
| 2021 | $193.32 | $87.24 | 2.22x | $106.08 | $874.6K | 10.8K | 1.9K |
| 2022 | $212.87 | $91.53 | 2.33x | $121.34 | $968.9K | 12.5K | 2.7K |
| 2023 | $214.07 | $96.88 | 2.21x | $117.19 | $1.4M | 16.2K | 2.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 22.1K | $1.9M | $87.44 | 2.17x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 22.3K | $1.4M | $64.72 | 1.99x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 4.2K | $403.1K | $94.87 | 4.21x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 1.6K | $251.9K | $154.42 | 1.32x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 2.7K | $174.0K | $64.82 | 4.15x |
| 99316 | Nursing facility discharge management, more than 30 minutes | 1.4K | $142.7K | $102.58 | 2.92x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 2.7K | $134.0K | $50.29 | 4.97x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 1.6K | $123.9K | $77.46 | 2.49x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 702 | $123.9K | $176.44 | 4.34x |
| 99239 | Hospital discharge day management, more than 30 minutes | 1.2K | $118.5K | $95.98 | 4.41x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 852 | $109.4K | $128.36 | 1.52x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 840 | $32.3K | $38.45 | 2.30x |
| 99349 | Established patient home visit, typically 40 minutes | 156 | $17.5K | $112.30 | 1.78x |
| 99238 | Hospital discharge day management, 30 minutes or less | 176 | $11.3K | $64.04 | 4.61x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 48 | $9.6K | $199.13 | 6.71x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 40 | $4.6K | $115.80 | 4.77x |
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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