This provider's $3.6M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 362% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 102% in 2021
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 | $179.63 | $54.09 | 3.32x | $125.54 | $168.8K | 4.5K | 3.3K |
| 2015 | $148.36 | $46.12 | 3.22x | $102.24 | $277.4K | 7.7K | 5.9K |
| 2016 | $141.77 | $47.86 | 2.96x | $93.91 | $362.4K | 9.9K | 7.8K |
| 2017 | $164.89 | $53.44 | 3.09x | $111.45 | $303.1K | 7.2K | 5.7K |
| 2018 | $144.81 | $48.94 | 2.96x | $95.87 | $224.7K | 6.2K | 4.7K |
| 2019 | $175.45 | $56.03 | 3.13x | $119.42 | $214.1K | 5.5K | 4.2K |
| 2020 | $109.17 | $43.97 | 2.48x | $65.20 | $184.0K | 4.7K | 3.3K |
| 2021 | $134.10 | $53.75 | 2.49x | $80.35 | $371.0K | 7.9K | 3.6K |
| 2022 | $163.62 | $54.21 | 3.02x | $109.41 | $673.3K | 14.3K | 4.2K |
| 2023 | $130.75 | $51.32 | 2.55x | $79.43 | $779.2K | 17.3K | 3.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 15.6K | $1.0M | $64.90 | 2.61x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 7.3K | $592.0K | $81.17 | 2.67x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 3.4K | $360.9K | $106.59 | 2.74x |
| 95923 | Testing of autonomic (sympathetic) nervous system function | 2.3K | $217.5K | $96.66 | 2.42x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 1.2K | $136.6K | $114.30 | 1.71x |
| 97035 | Application of ultrasound to 1 or more areas, each 15 minutes | 14.0K | $136.2K | $9.73 | 4.43x |
| 90670 | Pneumococcal vaccine for injection into muscle | 596 | $106.8K | $179.16 | 1.17x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 815 | $96.5K | $118.35 | 2.54x |
| 90662 | Vaccine for influenza for injection into muscle | 1.6K | $83.7K | $51.12 | 1.18x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 307 | $45.8K | $149.33 | 2.49x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 3.1K | $43.5K | $14.03 | 1.98x |
| 93923 | Ultrasound study of arteries of both arms and legs | 440 | $42.9K | $97.54 | 5.64x |
| G0008 | Administration of influenza virus vaccine | 1.7K | $38.7K | $22.50 | 1.88x |
| 92548 | Assessment of balance and postural instability | 474 | $36.8K | $77.72 | 1.79x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 98 | $33.1K | $337.66 | 5.09x |
| 96119 | Neuropsychological testing by technician with interpretation and report by a qualified healthcare professional per hour | 470 | $27.9K | $59.36 | 1.89x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 1.9K | $27.3K | $14.02 | 3.03x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 1.6K | $26.3K | $16.48 | 2.99x |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 83 | $22.8K | $275.30 | 1.06x |
| 83036 | Hemoglobin A1C level | 2.0K | $22.8K | $11.44 | 4.28x |
This provider submits charges 2.67 times higher than what Medicare actually pays.
A markup ratio of 2.67x means for every $100 Medicare pays, this provider initially charges $267. 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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