This provider's $5.0M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 2928% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1487% in 2019
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 | $422.05 | $151.97 | 2.78x | $270.08 | $39.8K | 278 | 277 |
| 2015 | $327.41 | $108.32 | 3.02x | $219.09 | $11.6K | 102 | 93 |
| 2016 | $339.88 | $129.66 | 2.62x | $210.22 | $6.8K | 50 | 43 |
| 2017 | $380.14 | $124.84 | 3.05x | $255.30 | $3.7K | 30 | 20 |
| 2018 | $174.07 | $114.69 | 1.52x | $59.38 | $7.6K | 73 | 49 |
| 2019 | $293.71 | $117.13 | 2.51x | $176.58 | $120.5K | 1.2K | 508 |
| 2020 | $270.66 | $98.88 | 2.74x | $171.78 | $749.3K | 7.3K | 3.4K |
| 2021 | $279.67 | $97.14 | 2.88x | $182.53 | $1.4M | 13.1K | 4.9K |
| 2022 | $349.62 | $117.43 | 2.98x | $232.19 | $1.5M | 13.8K | 5.1K |
| 2023 | $359.89 | $117.64 | 3.06x | $242.25 | $1.2M | 11.3K | 4.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99350 | Established patient home visit, typically 60 minutes | 11.4K | $1.7M | $148.14 | 3.28x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 18.0K | $1.3M | $71.07 | 2.95x |
| G0182 | Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patien | 8.4K | $780.6K | $93.28 | 1.93x |
| 99345 | New patient home visit, typically 75 minutes | 2.9K | $498.8K | $172.31 | 3.46x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 974 | $159.6K | $163.85 | 3.23x |
| 99354 | Prolonged office or other outpatient service first hour | 793 | $89.4K | $112.79 | 2.93x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 618 | $84.9K | $137.44 | 3.03x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 479 | $78.2K | $163.32 | 1.87x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 612 | $73.3K | $119.84 | 3.13x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 626 | $57.6K | $91.95 | 3.13x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 416 | $38.5K | $92.53 | 2.18x |
| 99328 | New patient assisted living visit, typically 75 minutes | 211 | $37.8K | $179.14 | 3.35x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 184 | $30.0K | $162.99 | 3.56x |
| G0181 | Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow | 324 | $29.9K | $92.39 | 1.95x |
| 99356 | Prolonged inpatient or observation hospital service first hour | 221 | $17.4K | $78.68 | 3.13x |
| G0179 | Physician or allowed practitioner 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 a | 275 | $10.1K | $36.90 | 3.25x |
| 99349 | Established patient home visit, typically 40 minutes | 84 | $8.7K | $103.99 | 3.37x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 141 | $7.9K | $56.07 | 2.51x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 48 | $6.2K | $129.49 | 2.00x |
| 99344 | New patient home visit, typically 60 minutes | 43 | $6.0K | $140.63 | 2.77x |
This provider submits charges 2.94 times higher than what Medicare actually pays.
A markup ratio of 2.94x means for every $100 Medicare pays, this provider initially charges $294. 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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