This provider's $3.5M in total Medicare payments ranks in the 99th percentile of Neurology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $206.99 | $119.97 | 1.73x | $87.02 | $343.7K | 3.6K | 1.7K |
| 2015 | $201.94 | $119.89 | 1.68x | $82.05 | $279.4K | 3.2K | 1.7K |
| 2016 | $196.47 | $110.01 | 1.79x | $86.46 | $324.9K | 4.0K | 2.1K |
| 2017 | $194.95 | $105.85 | 1.84x | $89.10 | $264.3K | 3.1K | 1.7K |
| 2018 | $199.09 | $116.40 | 1.71x | $82.69 | $396.1K | 4.7K | 2.4K |
| 2019 | $209.56 | $124.99 | 1.68x | $84.57 | $311.0K | 3.6K | 1.7K |
| 2020 | $183.43 | $113.21 | 1.62x | $70.22 | $383.6K | 4.4K | 2.0K |
| 2021 | $207.42 | $115.12 | 1.80x | $92.30 | $451.8K | 5.3K | 2.2K |
| 2022 | $205.02 | $103.03 | 1.99x | $101.99 | $318.2K | 3.8K | 2.0K |
| 2023 | $201.55 | $96.52 | 2.09x | $105.03 | $385.4K | 4.4K | 2.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 19.1K | $1.2M | $60.19 | 1.71x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.8K | $326.5K | $85.79 | 1.96x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 2.0K | $325.9K | $165.36 | 1.63x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 2.3K | $283.5K | $121.10 | 1.75x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 959 | $156.6K | $163.31 | 2.46x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.5K | $138.3K | $91.08 | 1.65x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 1.7K | $121.0K | $73.15 | 1.74x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 590 | $108.9K | $184.53 | 1.63x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 717 | $94.5K | $131.83 | 1.82x |
| 96132 | Neuropsychological testing evaluation by qualified health care professional, first 60 minutes | 852 | $89.6K | $105.16 | 1.88x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 532 | $87.6K | $164.69 | 1.85x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 759 | $84.9K | $111.82 | 1.53x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 635 | $71.6K | $112.75 | 1.64x |
| 96133 | Neuropsychological testing evaluation by qualified health care professional, additional 60 minutes | 853 | $70.9K | $83.11 | 1.84x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 506 | $68.7K | $135.77 | 1.67x |
| 90791 | Psychiatric diagnostic evaluation | 406 | $54.6K | $134.55 | 1.99x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 434 | $47.1K | $108.47 | 1.74x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 317 | $33.6K | $105.94 | 1.59x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 148 | $24.1K | $163.15 | 1.62x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 391 | $20.7K | $52.97 | 1.60x |
This provider submits charges 1.77 times higher than what Medicare actually pays.
A markup ratio of 1.77x means for every $100 Medicare pays, this provider initially charges $177. This is lower 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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