This provider's $4.3M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 211% from 2018 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 133% 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 |
|---|---|---|---|---|---|---|---|
| 2018 | $254.73 | $85.04 | 3.00x | $169.69 | $289.5K | 3.1K | 1.1K |
| 2019 | $285.38 | $92.44 | 3.09x | $192.94 | $673.2K | 7.8K | 2.9K |
| 2020 | $264.93 | $94.55 | 2.80x | $170.38 | $578.2K | 6.6K | 2.8K |
| 2021 | $264.48 | $102.08 | 2.59x | $162.40 | $828.4K | 8.9K | 3.2K |
| 2022 | $278.90 | $102.58 | 2.72x | $176.32 | $1.0M | 12.2K | 4.5K |
| 2023 | $277.42 | $91.49 | 3.03x | $185.93 | $899.8K | 11.0K | 3.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 13.3K | $857.2K | $64.42 | 3.80x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 9.7K | $838.7K | $86.07 | 4.03x |
| 11043 | Removal of skin and/or muscle first 20 sq cm or less | 4.2K | $793.2K | $188.01 | 2.77x |
| 11042 | Removal of skin and tissue first 20 sq cm or less | 6.3K | $452.1K | $71.47 | 3.66x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 1.3K | $205.5K | $153.22 | 2.89x |
| 17250 | Application of chemical agent to excessive wound tissue | 3.9K | $164.1K | $42.00 | 9.20x |
| 11044 | Removal of skin and bone first 20 sq cm or less | 563 | $142.2K | $252.66 | 2.35x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 1.1K | $130.1K | $116.97 | 3.01x |
| 99316 | Nursing facility discharge management, more than 30 minutes | 1.0K | $109.1K | $105.98 | 4.01x |
| 11046 | Removal of skin and/or muscle | 1.5K | $97.7K | $63.56 | 2.42x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 624 | $77.8K | $124.70 | 2.00x |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 345 | $58.5K | $169.45 | 1.48x |
| 11045 | Removal of skin and tissue | 1.5K | $45.0K | $30.73 | 4.59x |
| 99349 | Established patient home visit, typically 40 minutes | 378 | $44.4K | $117.36 | 3.13x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 1.0K | $41.8K | $39.91 | 3.50x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 258 | $32.6K | $126.46 | 2.69x |
| 90791 | Psychiatric diagnostic evaluation | 214 | $29.7K | $139.01 | 1.62x |
| 99304 | Initial nursing facility visit, typically 25 minutes per day | 358 | $29.4K | $82.17 | 2.59x |
| 11047 | Removal of skin and bone | 203 | $19.7K | $97.06 | 2.13x |
| 99358 | Prolonged patient service without direct patient contact first hour | 214 | $17.3K | $80.87 | 1.28x |
This provider submits charges 3.54 times higher than what Medicare actually pays.
A markup ratio of 3.54x means for every $100 Medicare pays, this provider initially charges $354. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
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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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