This provider's $5.7M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 887% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1284% in 2023
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 | $96.05 | $37.65 | 2.55x | $58.40 | $314.0K | 8.3K | 26 |
| 2015 | $83.12 | $29.03 | 2.86x | $54.09 | $251.4K | 8.7K | 31 |
| 2016 | $126.88 | $43.85 | 2.89x | $83.03 | $264.9K | 6.0K | 24 |
| 2017 | $102.18 | $34.51 | 2.96x | $67.67 | $268.7K | 7.8K | 24 |
| 2018 | $83.96 | $29.31 | 2.86x | $54.65 | $268.4K | 9.2K | 23 |
| 2019 | $65.53 | $23.84 | 2.75x | $41.69 | $378.1K | 15.9K | 28 |
| 2020 | $121.93 | $43.12 | 2.83x | $78.81 | $292.6K | 6.8K | 30 |
| 2021 | $86.85 | $33.92 | 2.56x | $52.93 | $345.1K | 10.2K | 28 |
| 2022 | $146.01 | $56.54 | 2.58x | $89.47 | $224.0K | 4.0K | 22 |
| 2023 | $1.0K | $628.32 | 1.66x | $412.42 | $3.1M | 4.9K | 19 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2507 | Injection, pegloticase, 1 mg | 1.2K | $2.9M | $2.5K | 1.54x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 13.3K | $761.2K | $57.21 | 2.90x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 6.4K | $509.4K | $80.06 | 2.93x |
| 95004 | Injection of allergenic extracts into skin, accessed through the skin | 35.0K | $154.1K | $4.41 | 2.95x |
| 93306 | Ultrasound of heart with color-depicted blood flow, rate, direction and valve function | 961 | $124.6K | $129.67 | 2.73x |
| 99495 | Transitional care management services for problem of at least moderate complexity | 588 | $81.5K | $138.53 | 2.48x |
| 93922 | Ultrasound study of arm and leg arteries | 1.1K | $77.9K | $68.48 | 2.82x |
| 99484 | Care management services for behavioral health conditions, 20 minutes or more clinical staff time directed by health care professional | 2.0K | $77.0K | $38.28 | 2.72x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 428 | $65.0K | $151.98 | 2.33x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 443 | $55.2K | $124.58 | 2.02x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 433 | $52.7K | $121.78 | 2.88x |
| 95943 | Testing of autonomic (parasympathetic and sympathetic) nervous system function | 678 | $51.5K | $75.95 | 3.45x |
| 77080 | Dxa bone density measurement of hip, pelvis, spine | 1.2K | $50.7K | $43.57 | 2.41x |
| 95811 | Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube | 78 | $42.3K | $542.26 | 2.66x |
| 99497 | Advance care planning, first 30 minutes | 604 | $38.8K | $64.25 | 2.66x |
| 95810 | Sleep monitoring of patient (6 years or older) in sleep lab | 73 | $38.2K | $523.77 | 2.62x |
| 94010 | Test to measure expiratory airflow and volume | 1.4K | $37.3K | $26.51 | 3.84x |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 1.2K | $33.3K | $27.33 | 2.08x |
| 93925 | Ultrasound of leg arteries or artery grafts | 171 | $32.7K | $191.44 | 2.50x |
| 95923 | Testing of autonomic (sympathetic) nervous system function | 270 | $29.3K | $108.45 | 3.69x |
This provider submits charges 2.16 times higher than what Medicare actually pays.
A markup ratio of 2.16x means for every $100 Medicare pays, this provider initially charges $216. 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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