This provider's $3.2M in total Medicare payments ranks in the 99th percentile of General Practice providers nationally.
Medicare payments to this provider grew 359% from 2019 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 99% in 2020
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 |
|---|---|---|---|---|---|---|---|
| 2019 | $140.50 | $89.43 | 1.57x | $51.07 | $237.4K | 2.3K | 749 |
| 2020 | $153.90 | $100.06 | 1.54x | $53.84 | $472.1K | 4.4K | 1.4K |
| 2021 | $158.47 | $100.92 | 1.57x | $57.55 | $620.4K | 5.4K | 1.4K |
| 2022 | $151.65 | $97.99 | 1.55x | $53.66 | $823.9K | 7.1K | 1.7K |
| 2023 | $158.45 | $105.26 | 1.51x | $53.19 | $1.1M | 8.7K | 2.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 11043 | Removal of skin and/or muscle first 20 sq cm or less | 4.9K | $789.4K | $161.90 | 1.63x |
| 11044 | Removal of skin and bone first 20 sq cm or less | 3.0K | $745.1K | $248.11 | 1.42x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 5.8K | $656.4K | $112.87 | 1.41x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 6.3K | $477.1K | $75.20 | 1.42x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 1.1K | $141.8K | $134.18 | 1.43x |
| 11047 | Removal of skin and bone | 1.1K | $101.6K | $96.26 | 1.45x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 1.9K | $100.3K | $53.84 | 1.45x |
| 11042 | Removal of skin and tissue first 20 sq cm or less | 1.3K | $82.2K | $61.82 | 2.35x |
| 11046 | Removal of skin and/or muscle | 852 | $49.2K | $57.80 | 1.44x |
| 17250 | Application of chemical agent to excessive wound tissue | 837 | $48.1K | $57.44 | 1.72x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 201 | $19.9K | $99.15 | 1.47x |
| 99304 | Initial nursing facility visit, typically 25 minutes per day | 206 | $14.5K | $70.15 | 1.47x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 187 | $6.3K | $33.76 | 1.49x |
| 10061 | Drainage of multiple abscess | 43 | $6.1K | $141.46 | 1.69x |
| 11045 | Removal of skin and tissue | 150 | $4.9K | $32.46 | 1.42x |
This provider submits charges 1.5 times higher than what Medicare actually pays.
A markup ratio of 1.5x means for every $100 Medicare pays, this provider initially charges $150. 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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