This provider's $11.3M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 490% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 155% in 2023
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 | $86.91 | $65.62 | 1.32x | $21.29 | $677.5K | 10.3K | 11 |
| 2015 | $85.72 | $63.65 | 1.35x | $22.07 | $571.8K | 9.0K | 12 |
| 2016 | $87.11 | $62.73 | 1.39x | $24.38 | $542.6K | 8.7K | 13 |
| 2017 | $91.50 | $64.73 | 1.41x | $26.77 | $628.6K | 9.7K | 13 |
| 2018 | $98.19 | $69.86 | 1.41x | $28.33 | $562.2K | 8.0K | 12 |
| 2019 | $99.09 | $72.84 | 1.36x | $26.25 | $710.2K | 9.8K | 16 |
| 2020 | $89.06 | $67.16 | 1.33x | $21.90 | $1.0M | 15.2K | 15 |
| 2021 | $88.32 | $66.77 | 1.32x | $21.55 | $1.0M | 15.4K | 18 |
| 2022 | $127.70 | $69.36 | 1.84x | $58.34 | $1.6M | 22.6K | 38 |
| 2023 | $397.24 | $286.05 | 1.39x | $111.19 | $4.0M | 14.0K | 28 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 72.4K | $4.7M | $65.09 | 1.37x |
| Q4217 | Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter | 2.8K | $3.2M | $1.2K | 1.30x |
| 99336 | Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes | 8.5K | $776.5K | $91.21 | 1.44x |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | 6.3K | $593.3K | $93.90 | 1.35x |
| 99335 | Established patient custodial care facility, group care, or assisted living visit, typically 25 minutes | 6.5K | $422.9K | $65.45 | 1.40x |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 6.1K | $298.4K | $49.22 | 1.36x |
| 95816 | Measurement of brain wave activity (eeg), awake and drowsy | 767 | $211.7K | $276.03 | 2.50x |
| 95957 | Measurement of brain wave activity (eeg), digital analysis | 766 | $149.1K | $194.66 | 2.42x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 1.8K | $147.8K | $83.58 | 1.59x |
| G0179 | Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a | 3.4K | $97.5K | $28.88 | 1.36x |
| 99497 | Advance care planning, first 30 minutes | 1.4K | $87.0K | $63.34 | 1.39x |
| G0180 | Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and | 1.9K | $72.6K | $37.97 | 1.34x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 737 | $39.6K | $53.74 | 1.30x |
| 99326 | New patient custodial care facility, group care, or assisted living visit, typically 45 minutes | 397 | $39.1K | $98.40 | 1.37x |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 275 | $34.7K | $126.31 | 1.57x |
| 99325 | New patient assisted living visit, typically 30 minutes | 611 | $33.5K | $54.77 | 1.42x |
| 99443 | Telephone medical discussion with physician, 21-30 minutes | 334 | $31.7K | $94.88 | 2.11x |
| 99458 | Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes | 764 | $22.5K | $29.47 | 5.10x |
| 96138 | Administration of psychological or neuropsychological test by technician, first 30 minutes | 808 | $19.8K | $24.48 | 2.70x |
| 99424 | Principal care management services for a single high-risk disease, first 30 minutes provided personally by qualified health care professional, per calendar month. | 311 | $19.4K | $62.49 | 2.80x |
This provider submits charges 1.43 times higher than what Medicare actually pays.
A markup ratio of 1.43x means for every $100 Medicare pays, this provider initially charges $143. 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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