This provider's $4.1M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 399% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 447% 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 | $475.26 | $85.37 | 5.57x | $389.89 | $169.3K | 1.5K | 792 |
| 2015 | $553.66 | $97.88 | 5.66x | $455.78 | $132.2K | 1.3K | 790 |
| 2016 | $582.76 | $90.45 | 6.44x | $492.31 | $60.7K | 744 | 531 |
| 2017 | $219.33 | $106.13 | 2.07x | $113.20 | $24.0K | 388 | 283 |
| 2018 | $289.51 | $103.13 | 2.81x | $186.38 | $53.8K | 612 | 504 |
| 2019 | $193.29 | $75.74 | 2.55x | $117.55 | $100.8K | 1.3K | 930 |
| 2020 | $223.38 | $94.13 | 2.37x | $129.25 | $228.1K | 2.4K | 1.5K |
| 2021 | $294.05 | $91.81 | 3.20x | $202.24 | $1.2M | 9.4K | 5.0K |
| 2022 | $204.37 | $91.78 | 2.23x | $112.59 | $1.3M | 9.2K | 4.9K |
| 2023 | $234.62 | $98.26 | 2.39x | $136.36 | $844.4K | 6.6K | 4.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99350 | Established patient home visit, typically 60 minutes | 11.4K | $1.9M | $165.74 | 2.49x |
| 99349 | Established patient home visit, typically 40 minutes | 6.5K | $760.7K | $117.06 | 2.52x |
| 99345 | New patient home visit, typically 75 minutes | 2.7K | $535.7K | $198.04 | 2.58x |
| 99344 | New patient home visit, typically 60 minutes | 1.5K | $234.6K | $154.13 | 2.75x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 1.1K | $191.6K | $177.58 | 7.42x |
| G0180 | Physician 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 to affirm the initial imple | 3.5K | $172.0K | $48.59 | 2.84x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 847 | $67.3K | $79.49 | 5.82x |
| G0179 | Physician 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 to affirm the initial im | 1.5K | $54.0K | $37.01 | 3.13x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 1.2K | $46.9K | $38.36 | 2.58x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 180 | $34.8K | $193.52 | 2.07x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 185 | $19.2K | $103.62 | 7.08x |
| 90674 | Vaccine for influenza for administration into muscle, 0.5 ml dosage | 546 | $17.2K | $31.49 | 1.43x |
| G0008 | Administration of influenza virus vaccine | 583 | $16.7K | $28.65 | 1.96x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 89 | $13.9K | $155.74 | 5.92x |
| 0011A | Adm sarscov2 100mcg/0.5ml1st | 204 | $9.0K | $44.23 | 1.51x |
| 36556 | Insertion of central venous catheter for infusion, patient 5 years or older | 89 | $8.5K | $95.42 | 9.32x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 132 | $7.4K | $55.68 | 5.78x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 45 | $6.8K | $151.70 | 2.08x |
| 0012A | Adm sarscov2 100mcg/0.5ml2nd | 128 | $5.7K | $44.89 | 1.49x |
| 90732 | Pneumococcal vaccine, 23-valent | 31 | $4.1K | $130.89 | 1.45x |
This provider submits charges 2.88 times higher than what Medicare actually pays.
A markup ratio of 2.88x means for every $100 Medicare pays, this provider initially charges $288. 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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