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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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ยฉ 2026 OpenMedicare. Independent data journalism. Built by TheDataProject.ai

Methodologyโ€ขDownload Data
  1. Home
  2. Providers
  3. Alfredo Melgar
๐Ÿฉบ
MDIndividual

Alfredo Melgar, MD

NPI: 1093981912
Miami, FL
10 years of data
Internal Medicine
$4.6M
Total Payments
11.4K
Beneficiaries
56.8K
Services
1.96x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$4.6M
Specialty median$84.0K

๐Ÿ“‹ Key Findings

1Billed $4.6M over 10 years
21.96x markup ratio
399th percentile in Internal Medicine by payments
4Payments surged 197% in 2018
51 procedure with >3x markup
โœ“ No flags detected

๐Ÿ”Ž Data Analysis

This provider's $4.6M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.

Medicare payments to this provider grew 1676% from 2014 to 2023.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

๐Ÿ“ˆ

Notable: Payments increased 197% in 2018

Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid โ€” the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$143.33$88.021.63x$55.31$60.5K881219
2015$137.50$89.291.54x$48.21$25.7K348175
2016$150.00$91.491.64x$58.51$46.2K472219
2017$146.25$79.871.83x$66.38$134.9K1.7K605
2018$180.00$93.301.93x$86.70$400.8K5.4K1.0K
2019$180.00$101.291.78x$78.71$621.5K7.0K1.3K
2020$154.50$87.011.78x$67.49$659.4K8.2K2.0K
2021$177.77$93.271.91x$84.50$656.1K8.3K1.4K
2022$220.22$92.892.37x$127.33$914.5K11.6K1.7K
2023$240.42$98.842.43x$141.58$1.1M12.8K2.8K

Top Procedures (20)

99309Subsequent nursing facility visit, typically 25 minutes per day
$2.3M
29.5K services$78.85/svc2.04x markup
99308Subsequent nursing facility visit, typically 15 minutes per day
$835.6K
14.4K services$58.00/svc1.90x markup
99336Established patient assisted living visit, typically 40 minutes
$777.3K
7.0K services$110.32/svc1.81x markup
99306Initial nursing facility visit, typically 45 minutes per day
$415.1K
3.0K services$140.55/svc1.71x markup
99335Established patient assisted living visit, typically 25 minutes
$48.3K
618 services$78.12/svc2.30x markup
99310Subsequent nursing facility visit, typically 35 minutes per day
$33.8K
290 services$116.43/svc2.44x markup
99316Nursing facility discharge management, more than 30 minutes
$26.4K
277 services$95.40/svc1.81x markup
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes
$24.7K
365 services$67.57/svc2.29x markup
99214Established patient office or other outpatient, visit typically 25 minutes
$17.8K
210 services$84.60/svc1.42x markup
99291Critical care, first 30-74 minutesโš  3.3x markup
$17.3K
93 services$186.02/svc3.31x markup
99315Nursing facility discharge day management, 30 minutes or less
$15.6K
243 services$64.10/svc2.63x markup
99305Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes
$15.0K
133 services$112.99/svc2.43x markup
99307Subsequent nursing facility visit, typically 10 minutes per day
$12.1K
365 services$33.26/svc2.81x markup
99326New patient assisted living visit, typically 45 minutes
$9.6K
85 services$113.08/svc2.21x markup
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes
$6.7K
45 services$148.00/svc2.92x markup
99442Physician telephone patient service, 11-20 minutes of medical discussion
$2.6K
43 services$61.45/svc1.63x markup
99238Hospital discharge day management, 30 minutes or less
$2.5K
37 services$68.58/svc2.38x markup
99443Physician telephone patient service, 21-30 minutes of medical discussion
$1.4K
18 services$77.88/svc1.85x markup
99239Hospital discharge day management, more than 30 minutes
$1.3K
13 services$97.83/svc2.31x markup
99213Established patient office or other outpatient visit, typically 15 minutes
$1.1K
18 services$61.93/svc1.61x markup
Show detailed table โ–พ
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
99309Subsequent nursing facility visit, typically 25 minutes per day29.5K$2.3M$78.852.04x
99308Subsequent nursing facility visit, typically 15 minutes per day14.4K$835.6K$58.001.90x
99336Established patient assisted living visit, typically 40 minutes7.0K$777.3K$110.321.81x
99306Initial nursing facility visit, typically 45 minutes per day3.0K$415.1K$140.551.71x
99335Established patient assisted living visit, typically 25 minutes618$48.3K$78.122.30x
99310Subsequent nursing facility visit, typically 35 minutes per day290$33.8K$116.432.44x
99316Nursing facility discharge management, more than 30 minutes277$26.4K$95.401.81x
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes365$24.7K$67.572.29x
99214Established patient office or other outpatient, visit typically 25 minutes210$17.8K$84.601.42x
99291Critical care, first 30-74 minutes93$17.3K$186.023.31x
99315Nursing facility discharge day management, 30 minutes or less243$15.6K$64.102.63x
99305Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes133$15.0K$112.992.43x
99307Subsequent nursing facility visit, typically 10 minutes per day365$12.1K$33.262.81x
99326New patient assisted living visit, typically 45 minutes85$9.6K$113.082.21x
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes45$6.7K$148.002.92x
99442Physician telephone patient service, 11-20 minutes of medical discussion43$2.6K$61.451.63x
99238Hospital discharge day management, 30 minutes or less37$2.5K$68.582.38x
99443Physician telephone patient service, 21-30 minutes of medical discussion18$1.4K$77.881.85x
99239Hospital discharge day management, more than 30 minutes13$1.3K$97.832.31x
99213Established patient office or other outpatient visit, typically 15 minutes18$1.1K$61.931.61x

Markup Analysis

Charge-to-Payment Ratio

1.96x

This provider submits charges 1.96 times higher than what Medicare actually pays.

What This Means

A markup ratio of 1.96x means for every $100 Medicare pays, this provider initially charges $196. This is lower than the national average.

Location

Miami, FL

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

Similar Providers

Other Internal Medicine providers in FL for peer comparison.

Alfredo Melgar (you)
$4.6M
Patrick Anastasio, D.O.
$39.5M
Steven Newman, MDโš ๏ธ
$35.4M
Abraham Schwarzberg, MD
$34.6M
Show detailed table โ–พ
ProviderLocationTotal PaymentsStatus
Patrick Anastasio, D.O.Fort Walton Beach, FL$39.5Mโœ“ Clear
Steven Newman, MDNaples, FL$35.4Mโš ๏ธ Flagged
Abraham Schwarzberg, MDPalm Springs, FL$34.6Mโœ“ Clear

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Data Sources

  • โ€ข Centers for Medicare & Medicaid Services (CMS)
  • โ€ข Medicare Provider Utilization and Payment Data (2014-2023)
  • โ€ข National Plan and Provider Enumeration System (NPPES)

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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