This provider's $4.7M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 104% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 50% in 2018
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 | $118.94 | $58.64 | 2.03x | $60.30 | $288.1K | 4.9K | 3.3K |
| 2015 | $136.96 | $53.84 | 2.54x | $83.12 | $284.8K | 5.1K | 3.7K |
| 2016 | $176.69 | $66.83 | 2.64x | $109.86 | $305.8K | 5.2K | 3.7K |
| 2017 | $156.59 | $69.93 | 2.24x | $86.66 | $393.4K | 5.9K | 4.2K |
| 2018 | $153.76 | $58.80 | 2.61x | $94.96 | $591.5K | 10.1K | 6.7K |
| 2019 | $169.30 | $62.13 | 2.72x | $107.17 | $624.7K | 10.2K | 6.7K |
| 2020 | $170.56 | $57.14 | 2.98x | $113.42 | $490.4K | 8.3K | 6.0K |
| 2021 | $171.12 | $65.77 | 2.60x | $105.35 | $573.6K | 7.8K | 5.5K |
| 2022 | $168.99 | $60.43 | 2.80x | $108.56 | $609.2K | 8.5K | 5.9K |
| 2023 | $183.59 | $60.29 | 3.05x | $123.30 | $586.3K | 8.3K | 5.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 16.3K | $1.4M | $85.45 | 2.96x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 17.1K | $976.3K | $56.97 | 3.08x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 6.5K | $829.0K | $127.51 | 2.14x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 1.2K | $255.2K | $207.52 | 2.60x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 2.9K | $178.6K | $60.90 | 2.87x |
| G0442 | Annual alcohol misuse screening, 15 minutes | 6.3K | $122.8K | $19.39 | 2.83x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 1.1K | $118.4K | $107.58 | 2.69x |
| G0444 | Annual depression screening, 15 minutes | 6.0K | $115.4K | $19.27 | 2.82x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 1.9K | $99.7K | $53.07 | 2.78x |
| 99443 | Physician telephone patient service, 21-30 minutes of medical discussion | 834 | $73.5K | $88.19 | 2.83x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 508 | $68.5K | $134.91 | 2.56x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 2.1K | $68.3K | $32.11 | 3.36x |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 299 | $50.9K | $170.36 | 1.70x |
| 99304 | Initial nursing facility visit, typically 25 minutes per day | 691 | $50.7K | $73.43 | 2.86x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 3.1K | $37.0K | $11.99 | 6.26x |
| 99495 | Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge | 194 | $28.3K | $146.13 | 2.65x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 533 | $25.2K | $47.36 | 3.01x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 739 | $24.3K | $32.94 | 4.27x |
| 69210 | Removal of impact ear wax, one ear | 582 | $21.0K | $36.02 | 3.13x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 266 | $20.6K | $77.41 | 2.26x |
This provider submits charges 2.8 times higher than what Medicare actually pays.
A markup ratio of 2.8x means for every $100 Medicare pays, this provider initially charges $280. 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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