This provider's $3.6M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 1119% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 78% in 2019
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 | $119.53 | $60.51 | 1.98x | $59.02 | $62.2K | 898 | 469 |
| 2015 | $106.61 | $54.92 | 1.94x | $51.69 | $62.2K | 893 | 458 |
| 2016 | $132.50 | $56.96 | 2.33x | $75.54 | $96.3K | 1.6K | 665 |
| 2017 | $198.96 | $104.95 | 1.90x | $94.01 | $137.2K | 1.4K | 559 |
| 2018 | $113.56 | $54.21 | 2.09x | $59.35 | $239.5K | 5.5K | 1.3K |
| 2019 | $99.00 | $46.40 | 2.13x | $52.60 | $425.5K | 12.4K | 2.0K |
| 2020 | $144.44 | $50.65 | 2.85x | $93.79 | $461.3K | 12.2K | 1.7K |
| 2021 | $127.93 | $54.43 | 2.35x | $73.50 | $630.4K | 15.3K | 2.4K |
| 2022 | $138.67 | $55.09 | 2.52x | $83.58 | $728.2K | 20.0K | 3.2K |
| 2023 | $139.97 | $52.85 | 2.65x | $87.12 | $758.7K | 22.4K | 3.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.5K | $576.4K | $105.65 | 2.43x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 3.1K | $418.4K | $134.87 | 2.54x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.5K | $396.6K | $72.39 | 2.39x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 4.0K | $376.5K | $92.96 | 2.18x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 5.2K | $341.9K | $65.16 | 2.26x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.6K | $268.4K | $173.18 | 2.29x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 3.6K | $242.3K | $66.45 | 2.66x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 5.5K | $158.6K | $29.06 | 2.64x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 15.0K | $118.5K | $7.89 | 2.68x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 517 | $74.3K | $143.78 | 2.29x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 1.1K | $69.0K | $64.64 | 2.61x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 564 | $66.4K | $117.64 | 2.20x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 417 | $59.2K | $142.05 | 2.56x |
| G0498 | Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted l | 324 | $53.6K | $165.53 | 1.61x |
| Q5122 | Injection, pegfilgrastim-apgf, biosimilar, (nyvepria), 0.5 mg | 320 | $52.8K | $165.08 | 3.06x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 836 | $38.3K | $45.81 | 2.29x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 2.5K | $36.1K | $14.22 | 2.66x |
| 96521 | Refilling and maintenance of portable pump | 237 | $31.2K | $131.58 | 2.05x |
| 36415 | Insertion of needle into vein for collection of blood sample | 6.2K | $26.2K | $4.21 | 2.46x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 126 | $23.4K | $186.08 | 2.55x |
This provider submits charges 2.45 times higher than what Medicare actually pays.
A markup ratio of 2.45x means for every $100 Medicare pays, this provider initially charges $245. 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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