This provider's $3.5M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 363% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 58% 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 |
|---|---|---|---|---|---|---|---|
| 2014 | $152.10 | $55.44 | 2.74x | $96.66 | $171.4K | 2.5K | 1.5K |
| 2015 | $207.42 | $56.62 | 3.66x | $150.80 | $117.4K | 2.2K | 1.5K |
| 2016 | $188.59 | $57.91 | 3.26x | $130.68 | $134.0K | 2.2K | 1.4K |
| 2017 | $195.21 | $70.86 | 2.75x | $124.35 | $163.6K | 2.6K | 1.6K |
| 2018 | $150.35 | $76.59 | 1.96x | $73.76 | $258.1K | 3.4K | 2.2K |
| 2019 | $142.88 | $74.79 | 1.91x | $68.09 | $338.6K | 4.0K | 2.3K |
| 2020 | $138.67 | $76.23 | 1.82x | $62.44 | $401.4K | 4.5K | 1.8K |
| 2021 | $180.67 | $110.54 | 1.63x | $70.13 | $518.0K | 6.4K | 2.2K |
| 2022 | $193.81 | $118.52 | 1.64x | $75.29 | $631.3K | 8.0K | 2.5K |
| 2023 | $185.24 | $114.87 | 1.61x | $70.37 | $793.2K | 10.2K | 3.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99336 | Established patient assisted living visit, typically 40 minutes | 9.4K | $978.8K | $104.09 | 2.09x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 8.7K | $386.6K | $44.45 | 1.92x |
| 99349 | Established patient home visit, typically 40 minutes | 3.6K | $342.9K | $96.37 | 1.56x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.3K | $318.3K | $73.61 | 2.98x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 1.9K | $237.8K | $122.51 | 1.93x |
| 99328 | New patient assisted living visit, typically 75 minutes | 948 | $154.0K | $162.48 | 1.88x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 996 | $149.8K | $150.38 | 1.78x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 1.8K | $145.3K | $81.91 | 2.01x |
| 99439 | Chronic care management services, each additional 20 minutes of clinical staff time per calendar month | 3.7K | $135.9K | $36.77 | 2.32x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 641 | $135.0K | $210.66 | 1.43x |
| 99483 | Assessment of and care planning for patient with impaired thought processing, typically 50 minutes | 524 | $115.7K | $220.74 | 1.44x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.2K | $58.1K | $47.68 | 3.20x |
| 99345 | New patient home visit, typically 75 minutes | 295 | $43.4K | $147.16 | 1.80x |
| G0506 | Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) | 800 | $39.7K | $49.57 | 1.71x |
| G0179 | Physician 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 to affirm the initial im | 1.0K | $33.4K | $32.13 | 2.86x |
| 99487 | Complex chronic care management services 60 minutes clinical staff time | 437 | $32.9K | $75.26 | 2.32x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 241 | $25.9K | $107.33 | 2.59x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 292 | $22.1K | $75.56 | 1.86x |
| G0180 | Physician 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 to affirm the initial imple | 477 | $20.3K | $42.65 | 2.65x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 121 | $13.4K | $110.70 | 1.56x |
This provider submits charges 2.1 times higher than what Medicare actually pays.
A markup ratio of 2.1x means for every $100 Medicare pays, this provider initially charges $210. 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.
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data