This provider's $5.3M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 24330% from 2017 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 6982% in 2018
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 |
|---|---|---|---|---|---|---|---|
| 2017 | $284.24 | $106.97 | 2.66x | $177.27 | $2.7K | 25 | 25 |
| 2018 | $332.65 | $104.23 | 3.19x | $228.42 | $189.4K | 1.9K | 765 |
| 2019 | $351.06 | $108.52 | 3.23x | $242.54 | $901.1K | 7.0K | 1.6K |
| 2020 | $331.64 | $98.96 | 3.35x | $232.68 | $2.1M | 16.6K | 3.6K |
| 2021 | $318.67 | $94.85 | 3.36x | $223.82 | $773.3K | 8.2K | 2.7K |
| 2022 | $407.47 | $123.17 | 3.31x | $284.30 | $662.1K | 5.1K | 1.9K |
| 2023 | $335.76 | $89.61 | 3.75x | $246.15 | $653.3K | 9.2K | 2.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 11043 | Removal of skin and/or muscle first 20 sq cm or less | 7.6K | $1.5M | $194.04 | 2.63x |
| 99349 | Established patient home visit, typically 40 minutes | 8.0K | $875.2K | $109.48 | 3.65x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 7.2K | $568.5K | $78.62 | 2.90x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 2.9K | $332.9K | $113.58 | 3.91x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 3.7K | $234.1K | $63.08 | 4.41x |
| 11044 | Removal of skin and bone first 20 sq cm or less | 658 | $172.0K | $261.36 | 2.67x |
| 99233 | Follow-up hospital inpatient care per day, typically 35 minutes | 1.3K | $123.2K | $95.79 | 3.47x |
| 97610 | Therapy procedure using ultrasound | 280 | $121.5K | $433.91 | 3.80x |
| 11042 | Removal of skin and tissue first 20 sq cm or less | 1.5K | $119.4K | $78.42 | 3.38x |
| 11046 | Removal of skin and/or muscle | 1.9K | $117.0K | $62.62 | 2.58x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 1.1K | $113.5K | $99.67 | 2.86x |
| 99498 | Advance care planning by the physician or other qualified health care professional | 1.6K | $99.0K | $60.56 | 4.01x |
| 99344 | New patient home visit, typically 60 minutes | 552 | $82.9K | $150.21 | 3.78x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 1.4K | $79.7K | $56.44 | 2.97x |
| 99223 | Initial hospital inpatient care per day, typically 70 minutes | 452 | $66.1K | $146.14 | 4.40x |
| 15271 | Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms, or legs (first 25 sq cm or less) | 527 | $64.5K | $122.43 | 3.65x |
| Q4158 | Kerecis omega3, per square centimeter | 131 | $59.3K | $452.30 | 1.27x |
| 17110 | Destruction of up to 14 skin growths | 628 | $52.5K | $83.58 | 3.05x |
| 99232 | Follow-up hospital inpatient care per day, typically 25 minutes | 634 | $41.0K | $64.73 | 3.55x |
| 99442 | Telephone medical discussion with physician, 11-20 minutes | 472 | $37.0K | $78.31 | 3.83x |
This provider submits charges 3.22 times higher than what Medicare actually pays.
A markup ratio of 3.22x means for every $100 Medicare pays, this provider initially charges $322. 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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