⚠️ This provider averages 336 services per working day — physically unusual for an individual practitioner
Based on 336.3K total services over 4 years (250 working days/year). Learn about impossible service volumes →
This provider's $5.9M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Averaging 336 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 8100% from 2020 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 2237% 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 | $120.82 | $44.09 | 2.74x | $76.73 | $45.3K | 1.0K | 13 |
| 2021 | $95.22 | $43.87 | 2.17x | $51.35 | $1.1M | 24.1K | 41 |
| 2022 | $93.45 | $37.51 | 2.49x | $55.94 | $1.0M | 27.5K | 40 |
| 2023 | $25.12 | $13.10 | 1.92x | $12.02 | $3.7M | 283.7K | 10 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 274.3K | $3.2M | $11.76 | 1.71x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 11.8K | $579.2K | $49.03 | 2.96x |
| 99457 | Management using the results of remote vital sign monitoring per calendar month, first 20 minutes | 6.0K | $263.6K | $43.94 | 2.39x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 3.1K | $254.6K | $81.55 | 2.07x |
| 98976 | Device supply with scheduled recording and transmission for remote monitoring of respiratory system, per 30 days | 4.9K | $216.7K | $44.22 | 3.39x |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 4.4K | $200.9K | $45.29 | 2.29x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1.6K | $180.3K | $114.63 | 2.14x |
| 99453 | Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment | 4.7K | $84.1K | $17.72 | 2.60x |
| 0064A | Adm sarscov2 50mcg/0.25mlbst | 2.2K | $82.3K | $37.27 | 2.15x |
| 99458 | Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes | 2.3K | $80.4K | $35.49 | 2.68x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 484 | $75.1K | $155.23 | 2.10x |
| 90694 | Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, for injection into muscle, 0.5 ml dosage | 1.1K | $69.4K | $65.38 | 2.41x |
| 90662 | Influenza vaccine split virus, preservative free | 1.0K | $67.2K | $65.00 | 2.36x |
| 0013A | Adm sarscov2 100mcg/0.5ml3rd | 1.4K | $51.1K | $37.73 | 2.12x |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | 1.3K | $44.6K | $35.30 | 3.05x |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 847 | $43.4K | $51.27 | 2.15x |
| G0008 | Administration of influenza virus vaccine | 2.4K | $41.6K | $17.19 | 2.14x |
| 0031A | Adm sarscov2 vac ad26 .5ml | 1.1K | $39.2K | $36.36 | 2.17x |
| 0003A | Adm sarscov2 30mcg/0.3ml 3rd | 847 | $31.7K | $37.46 | 2.13x |
| 98980 | Remote therapeutic monitoring treatment management services by physician or other qualified health care professional, first 20 minutes per calendar month | 577 | $24.3K | $42.08 | 2.38x |
This provider submits charges 2.07 times higher than what Medicare actually pays.
A markup ratio of 2.07x means for every $100 Medicare pays, this provider initially charges $207. 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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