This provider's $4.4M in total Medicare payments ranks in the 99th percentile of Critical Care (Intensivists) providers nationally.
Their average markup ratio of 5.73x is significantly above the specialty median of 3.7x.
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 | $285.00 | $50.54 | 5.64x | $234.46 | $404.5K | 7.2K | 4.4K |
| 2015 | $342.72 | $55.66 | 6.16x | $287.06 | $487.8K | 8.4K | 5.3K |
| 2016 | $351.23 | $56.52 | 6.21x | $294.71 | $460.5K | 8.1K | 5.1K |
| 2017 | $364.69 | $61.67 | 5.91x | $303.02 | $446.6K | 7.7K | 4.9K |
| 2018 | $372.71 | $61.71 | 6.04x | $311.00 | $410.5K | 7.2K | 4.7K |
| 2019 | $307.35 | $59.09 | 5.20x | $248.26 | $401.1K | 6.9K | 4.6K |
| 2020 | $308.34 | $60.78 | 5.07x | $247.56 | $377.5K | 6.2K | 4.5K |
| 2021 | $309.56 | $61.66 | 5.02x | $247.90 | $417.9K | 5.7K | 4.1K |
| 2022 | $365.37 | $67.54 | 5.41x | $297.83 | $464.1K | 6.5K | 4.4K |
| 2023 | $339.99 | $60.59 | 5.61x | $279.40 | $489.0K | 8.2K | 5.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 8.2K | $838.7K | $102.23 | 5.03x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 11.7K | $806.9K | $69.18 | 5.62x |
| 95800 | Study of sleep patterns | 3.5K | $548.3K | $158.20 | 7.38x |
| 94060 | Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration | 7.4K | $402.4K | $54.08 | 5.89x |
| 94729 | Measurement of lung diffusing capacity | 4.3K | $227.6K | $53.13 | 5.42x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.4K | $216.3K | $150.12 | 5.11x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.1K | $193.2K | $92.42 | 6.72x |
| 94727 | Determination of lung volumes using gas dilution or washout | 3.6K | $147.6K | $40.55 | 5.55x |
| 71046 | X-ray of chest, 2 views | 3.4K | $103.1K | $30.52 | 5.51x |
| 94010 | Measurement and graphic recording of total and timed exhaled air capacity | 3.3K | $92.1K | $28.20 | 6.63x |
| 90670 | Pneumococcal vaccine for injection into muscle | 290 | $51.9K | $178.82 | 1.72x |
| 90662 | Vaccine for influenza for injection into muscle | 910 | $50.1K | $55.09 | 2.90x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 354 | $49.2K | $138.86 | 5.72x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 250 | $46.9K | $187.67 | 4.97x |
| 95012 | Measurement of inhaled nitric oxide gas | 2.4K | $45.0K | $18.73 | 7.24x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 957 | $39.8K | $41.63 | 5.32x |
| 71020 | X-ray of chest, 2 views, front and side | 1.4K | $36.9K | $25.87 | 7.56x |
| 94750 | Measurement of lung stretching capacity | 446 | $35.5K | $79.61 | 5.46x |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 119 | $33.2K | $278.98 | 2.92x |
| G0008 | Administration of influenza virus vaccine | 1.1K | $30.7K | $26.80 | 3.15x |
This provider submits charges 5.73 times higher than what Medicare actually pays.
A markup ratio of 5.73x means for every $100 Medicare pays, this provider initially charges $573. 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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