This provider's $5.2M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Their average markup ratio of 5.3x is significantly above the specialty median of 2.9x.
AI-generated analysis based on Medicare payment data.
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 | $171.86 | $46.31 | 3.71x | $125.55 | $489.8K | 14.6K | 7.4K |
| 2015 | $351.39 | $78.22 | 4.49x | $273.17 | $501.7K | 11.7K | 5.4K |
| 2016 | $369.79 | $77.22 | 4.79x | $292.57 | $489.2K | 11.9K | 5.5K |
| 2017 | $320.56 | $75.02 | 4.27x | $245.54 | $511.4K | 12.1K | 5.6K |
| 2018 | $363.67 | $75.86 | 4.79x | $287.81 | $511.8K | 11.4K | 5.7K |
| 2019 | $381.39 | $81.97 | 4.65x | $299.42 | $524.0K | 9.7K | 5.4K |
| 2020 | $508.66 | $78.79 | 6.46x | $429.87 | $465.0K | 10.2K | 5.8K |
| 2021 | $526.91 | $73.13 | 7.21x | $453.78 | $594.0K | 12.0K | 6.3K |
| 2022 | $524.78 | $78.45 | 6.69x | $446.33 | $550.5K | 11.2K | 5.9K |
| 2023 | $523.93 | $79.68 | 6.58x | $444.25 | $612.6K | 11.9K | 6.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 19.0K | $1.9M | $98.35 | 4.84x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 11.2K | $737.1K | $65.95 | 4.41x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 3.1K | $584.5K | $191.58 | 8.08x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 26.8K | $382.9K | $14.30 | 7.75x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 5.8K | $245.6K | $42.07 | 4.37x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 1.4K | $193.1K | $142.17 | 4.09x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 2.2K | $144.5K | $64.79 | 4.60x |
| 90662 | Vaccine for influenza for injection into muscle | 2.2K | $121.8K | $56.55 | 2.26x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.0K | $97.0K | $93.84 | 4.27x |
| 36415 | Insertion of needle into vein for collection of blood sample | 20.9K | $76.4K | $3.66 | 5.19x |
| G0008 | Administration of influenza virus vaccine | 2.9K | $76.0K | $26.20 | 2.68x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 400 | $73.6K | $184.02 | 4.62x |
| 93351 | Ultrasound examination and continuous monitoring of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report | 289 | $65.6K | $227.10 | 6.45x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 447 | $62.4K | $139.63 | 5.62x |
| 90670 | Pneumococcal vaccine for injection into muscle | 279 | $51.7K | $185.39 | 2.33x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 378 | $46.8K | $123.73 | 3.75x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 799 | $46.6K | $58.27 | 10.15x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 223 | $41.4K | $185.86 | 7.75x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 227 | $41.4K | $182.33 | 3.69x |
| 93224 | Heart rhythm tracing, analysis, and interpretation of 48-hour EKG | 385 | $28.2K | $73.14 | 11.12x |
This provider submits charges 5.3 times higher than what Medicare actually pays.
A markup ratio of 5.3x means for every $100 Medicare pays, this provider initially charges $530. 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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