This provider's $4.1M in total Medicare payments ranks in the 99th percentile of Geriatric 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 | $155.52 | $78.58 | 1.98x | $76.94 | $597.1K | 7.7K | 3.8K |
| 2015 | $149.27 | $82.59 | 1.81x | $66.68 | $565.4K | 7.4K | 4.3K |
| 2016 | $158.21 | $82.59 | 1.92x | $75.62 | $568.7K | 7.4K | 3.8K |
| 2017 | $164.09 | $77.73 | 2.11x | $86.36 | $349.1K | 5.0K | 2.9K |
| 2018 | $159.19 | $79.97 | 1.99x | $79.22 | $307.0K | 4.3K | 2.1K |
| 2019 | $164.05 | $83.39 | 1.97x | $80.66 | $356.5K | 4.9K | 2.2K |
| 2020 | $167.75 | $83.05 | 2.02x | $84.70 | $331.0K | 4.3K | 1.8K |
| 2021 | $144.46 | $76.25 | 1.89x | $68.21 | $307.4K | 4.0K | 1.4K |
| 2022 | $137.29 | $73.02 | 1.88x | $64.27 | $321.5K | 4.6K | 1.9K |
| 2023 | $139.57 | $75.32 | 1.85x | $64.25 | $436.9K | 5.8K | 1.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 19.0K | $1.2M | $64.61 | 2.18x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 7.6K | $739.8K | $97.78 | 1.69x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 3.6K | $438.1K | $120.79 | 1.63x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 5.3K | $251.6K | $47.14 | 2.22x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 2.3K | $216.2K | $92.79 | 1.62x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 2.0K | $191.3K | $94.40 | 1.72x |
| 99491 | Chronic care management services for two or more chronic conditions, first 30 minutes provided personally by health care professional, per calendar month | 2.2K | $131.9K | $61.17 | 1.69x |
| 99316 | Nursing facility discharge management, more than 30 minutes | 1.2K | $89.0K | $76.51 | 1.63x |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 646 | $87.5K | $135.50 | 1.65x |
| 99315 | Nursing facility discharge day management, 30 minutes or less | 1.5K | $78.1K | $53.58 | 1.77x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 1.1K | $76.9K | $66.85 | 2.22x |
| 76770 | Ultrasound behind abdominal cavity | 1.0K | $72.8K | $70.43 | 2.48x |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time per calendar month | 1.4K | $62.7K | $43.69 | 1.69x |
| 99349 | Established patient home visit, typically 40 minutes | 673 | $60.9K | $90.47 | 1.66x |
| 99214 | Established patient outpatient visit, total time 30-39 minutes | 644 | $53.2K | $82.54 | 2.12x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 403 | $50.4K | $125.08 | 2.36x |
| 93923 | Ultrasound study of arteries of both arms and legs | 538 | $45.9K | $85.34 | 3.22x |
| 93882 | Ultrasound scanning of blood flow (outside of brain) on one side of head and neck or limited | 497 | $39.3K | $79.15 | 2.59x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 199 | $27.2K | $136.66 | 1.43x |
| 99328 | New patient assisted living visit, typically 75 minutes | 169 | $26.5K | $156.66 | 1.60x |
This provider submits charges 1.93 times higher than what Medicare actually pays.
A markup ratio of 1.93x means for every $100 Medicare pays, this provider initially charges $193. 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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