This provider's $5.0M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $60.84 | $47.45 | 1.28x | $13.39 | $487.1K | 9.1K | 5.6K |
| 2015 | $66.51 | $52.66 | 1.26x | $13.85 | $518.1K | 8.8K | 5.6K |
| 2016 | $63.41 | $49.34 | 1.29x | $14.07 | $480.7K | 7.9K | 5.3K |
| 2017 | $61.32 | $45.42 | 1.35x | $15.90 | $419.5K | 8.6K | 6.0K |
| 2018 | $78.51 | $57.38 | 1.37x | $21.13 | $437.4K | 9.5K | 7.1K |
| 2019 | $76.31 | $53.09 | 1.44x | $23.22 | $450.4K | 9.5K | 7.3K |
| 2020 | $75.17 | $54.39 | 1.38x | $20.78 | $420.0K | 8.6K | 6.5K |
| 2021 | $88.02 | $60.47 | 1.46x | $27.55 | $492.7K | 8.6K | 6.6K |
| 2022 | $99.40 | $68.24 | 1.46x | $31.16 | $654.9K | 9.3K | 6.9K |
| 2023 | $98.32 | $68.05 | 1.44x | $30.27 | $627.7K | 9.0K | 6.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 23.0K | $1.7M | $73.36 | 1.77x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 8.1K | $1.0M | $129.65 | 1.04x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 9.6K | $480.1K | $50.08 | 1.77x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 1.1K | $220.4K | $204.63 | 1.31x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 829 | $149.2K | $180.03 | 1.05x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.3K | $149.1K | $115.66 | 1.60x |
| 69210 | Removal of impact ear wax, one ear | 3.8K | $143.9K | $37.52 | 1.51x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 4.0K | $131.0K | $32.51 | 1.62x |
| G0442 | Annual alcohol misuse screening, 15 minutes | 6.3K | $126.6K | $20.09 | 1.13x |
| 90662 | Vaccine for influenza for injection into muscle | 2.0K | $124.9K | $61.74 | 1.08x |
| G0444 | Annual depression screening, 15 minutes | 5.4K | $108.2K | $20.00 | 1.13x |
| G0008 | Administration of influenza virus vaccine | 3.5K | $87.9K | $24.90 | 1.24x |
| 99495 | Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge | 451 | $65.8K | $145.92 | 1.37x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 768 | $65.0K | $84.58 | 1.13x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 3.4K | $57.6K | $17.11 | 1.68x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 1.1K | $53.4K | $49.53 | 1.44x |
| 99349 | Established patient home visit, typically 40 minutes | 455 | $40.4K | $88.88 | 1.76x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 269 | $36.3K | $134.76 | 1.44x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 2.4K | $30.5K | $12.83 | 1.70x |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 171 | $30.1K | $175.79 | 1.08x |
This provider submits charges 1.46 times higher than what Medicare actually pays.
A markup ratio of 1.46x means for every $100 Medicare pays, this provider initially charges $146. 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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