This provider's $3.4M in total Medicare payments ranks in the 99th percentile of Infectious Disease providers nationally.
Medicare payments to this provider grew 90% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
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 | $201.00 | $98.77 | 2.04x | $102.23 | $277.4K | 3.2K | 1.4K |
| 2015 | $224.83 | $107.54 | 2.09x | $117.29 | $251.0K | 2.7K | 1.2K |
| 2016 | $198.06 | $95.03 | 2.08x | $103.03 | $262.9K | 3.0K | 1.2K |
| 2017 | $180.67 | $90.55 | 2.00x | $90.12 | $268.1K | 2.9K | 1.2K |
| 2018 | $180.67 | $90.65 | 1.99x | $90.02 | $285.1K | 3.3K | 1.5K |
| 2019 | $169.85 | $82.79 | 2.05x | $87.06 | $303.3K | 3.8K | 1.6K |
| 2020 | $157.38 | $76.85 | 2.05x | $80.53 | $427.3K | 5.4K | 1.9K |
| 2021 | $165.71 | $78.95 | 2.10x | $86.76 | $373.1K | 4.9K | 1.5K |
| 2022 | $165.71 | $76.67 | 2.16x | $89.04 | $427.3K | 5.9K | 1.8K |
| 2023 | $163.75 | $75.24 | 2.18x | $88.51 | $528.2K | 7.1K | 1.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 24.7K | $1.6M | $64.51 | 2.55x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 8.1K | $717.6K | $88.86 | 2.63x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 4.6K | $546.8K | $117.72 | 1.86x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 2.3K | $392.8K | $170.10 | 1.64x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 872 | $59.2K | $67.85 | 1.77x |
| 99358 | Prolonged patient service without direct patient contact first hour | 294 | $29.5K | $100.19 | 1.80x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 789 | $28.5K | $36.08 | 3.24x |
| 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 implem | 265 | $12.5K | $47.26 | 1.90x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 115 | $8.9K | $77.39 | 2.58x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 60 | $8.1K | $134.87 | 1.61x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 80 | $6.7K | $83.79 | 2.82x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 18 | $2.3K | $127.74 | 1.96x |
This provider submits charges 2.33 times higher than what Medicare actually pays.
A markup ratio of 2.33x means for every $100 Medicare pays, this provider initially charges $233. 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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