This provider averages 53 services per working day
Based on 132.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $9.9M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Averaging 53 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 194% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 56% in 2017
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 | $189.29 | $73.44 | 2.58x | $115.85 | $493.1K | 7.6K | 3.2K |
| 2015 | $172.77 | $76.89 | 2.25x | $95.88 | $507.6K | 7.2K | 3.0K |
| 2016 | $172.43 | $74.09 | 2.33x | $98.34 | $549.0K | 7.8K | 3.2K |
| 2017 | $181.00 | $77.79 | 2.33x | $103.21 | $854.4K | 12.7K | 4.7K |
| 2018 | $173.89 | $74.86 | 2.32x | $99.03 | $897.2K | 13.0K | 5.0K |
| 2019 | $188.39 | $81.02 | 2.33x | $107.37 | $1.3M | 17.2K | 5.8K |
| 2020 | $181.47 | $77.52 | 2.34x | $103.95 | $1.7M | 21.9K | 5.8K |
| 2021 | $201.89 | $93.07 | 2.17x | $108.82 | $942.7K | 10.8K | 4.6K |
| 2022 | $182.09 | $82.00 | 2.22x | $100.09 | $1.2M | 15.7K | 6.4K |
| 2023 | $200.27 | $87.20 | 2.30x | $113.07 | $1.5M | 18.8K | 6.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 16.0K | $1.5M | $95.64 | 2.09x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 13.1K | $1.2M | $88.99 | 2.76x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 12.4K | $819.7K | $66.24 | 2.19x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 11.0K | $753.9K | $68.47 | 2.51x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 3.9K | $651.4K | $166.61 | 2.05x |
| 99358 | Prolonged patient service without direct patient contact first hour | 5.4K | $506.0K | $94.25 | 1.96x |
| 99483 | Assessment of and care planning for patient with impaired thought processing, typically 50 minutes | 2.4K | $407.1K | $167.75 | 2.05x |
| 99491 | Chronic care management services by qualified health care professional, 30 minutes or more per calendar month | 4.9K | $347.4K | $71.20 | 2.11x |
| 96369 | Infusion into tissue for therapy or prevention up to 1 hour | 2.0K | $307.3K | $151.69 | 2.31x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 5.8K | $194.9K | $33.65 | 2.27x |
| 99443 | Telephone medical discussion with physician, 21-30 minutes | 1.8K | $186.7K | $105.84 | 1.42x |
| 99239 | Hospital discharge day management, more than 30 minutes | 2.0K | $179.5K | $90.01 | 2.53x |
| 98929 | Osteopathic manipulative treatment to 9-10 body regions | 2.4K | $174.6K | $72.54 | 3.45x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 1.2K | $157.9K | $130.79 | 1.91x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 3.0K | $140.3K | $47.25 | 1.71x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 2.9K | $138.3K | $47.25 | 2.12x |
| 99457 | Management using the results of remote vital sign monitoring per calendar month, first 20 minutes | 3.1K | $129.0K | $42.16 | 1.81x |
| 98928 | Osteopathic manipulative treatment to 7-8 body regions | 2.0K | $126.4K | $62.44 | 4.00x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 1.5K | $116.8K | $78.48 | 1.91x |
| 96371 | Infusion for therapy or prevention, beneath the skin | 2.0K | $111.9K | $55.35 | 1.61x |
This provider submits charges 2.29 times higher than what Medicare actually pays.
A markup ratio of 2.29x means for every $100 Medicare pays, this provider initially charges $229. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
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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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