This provider's $4.0M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 147% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 59% in 2015
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 | $1.0K | $253.65 | 4.00x | $761.00 | $191.1K | 1.1K | 693 |
| 2015 | $912.21 | $225.55 | 4.04x | $686.66 | $303.5K | 1.8K | 1.1K |
| 2016 | $860.50 | $206.25 | 4.17x | $654.25 | $376.0K | 2.3K | 1.4K |
| 2017 | $783.02 | $193.62 | 4.04x | $589.40 | $385.0K | 2.5K | 1.4K |
| 2018 | $661.17 | $177.82 | 3.72x | $483.35 | $401.2K | 2.5K | 1.5K |
| 2019 | $650.69 | $160.53 | 4.05x | $490.16 | $454.4K | 3.1K | 1.8K |
| 2020 | $796.38 | $206.12 | 3.86x | $590.26 | $431.0K | 3.2K | 1.7K |
| 2021 | $881.55 | $234.47 | 3.76x | $647.08 | $528.5K | 3.6K | 1.9K |
| 2022 | $634.70 | $185.45 | 3.42x | $449.25 | $489.2K | 3.3K | 1.9K |
| 2023 | $634.77 | $178.78 | 3.55x | $455.99 | $472.0K | 3.1K | 2.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 16.2K | $1.4M | $84.66 | 2.36x |
| 95811 | Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube | 2.4K | $1.2M | $508.85 | 4.26x |
| 95810 | Sleep monitoring of patient (6 years or older) in sleep lab | 1.8K | $884.4K | $484.36 | 3.72x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.1K | $240.6K | $116.25 | 2.14x |
| G0399 | Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation | 2.0K | $180.5K | $88.15 | 5.67x |
| 95805 | Diagnostic test for sleep disorder | 155 | $50.6K | $326.13 | 5.17x |
| 95807 | Sleep study attended by a technician | 103 | $22.8K | $221.28 | 4.36x |
| 94762 | Overnight measurement of oxygen saturation in blood using ear or finger device | 1.1K | $22.2K | $19.86 | 4.70x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 134 | $20.7K | $154.21 | 2.14x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 346 | $17.9K | $51.60 | 2.24x |
| 95800 | Study of sleep patterns | 152 | $10.2K | $67.43 | 6.48x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 63 | $7.6K | $120.27 | 1.91x |
| 95806 | Unattended sleep study with recording of heart rate, oxygen, respiratory airflow and effort | 59 | $2.4K | $41.49 | 3.52x |
| 94010 | Measurement and graphic recording of total and timed exhaled air capacity | 16 | $328.42 | $20.53 | 3.93x |
This provider submits charges 3.43 times higher than what Medicare actually pays.
A markup ratio of 3.43x means for every $100 Medicare pays, this provider initially charges $343. 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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