This provider's $5.7M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 4866% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 256% in 2016
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 | $75.47 | $43.04 | 1.75x | $32.43 | $21.9K | 402 | 367 |
| 2015 | $87.11 | $57.31 | 1.52x | $29.80 | $69.5K | 1.0K | 821 |
| 2016 | $78.64 | $53.23 | 1.48x | $25.41 | $247.8K | 4.2K | 1.5K |
| 2017 | $58.58 | $43.39 | 1.35x | $15.19 | $305.9K | 4.5K | 2.0K |
| 2018 | $71.79 | $55.19 | 1.30x | $16.60 | $491.0K | 7.0K | 2.2K |
| 2019 | $84.71 | $62.76 | 1.35x | $21.95 | $534.2K | 8.0K | 2.9K |
| 2020 | $98.16 | $71.10 | 1.38x | $27.06 | $633.9K | 8.1K | 3.4K |
| 2021 | $118.83 | $89.35 | 1.33x | $29.48 | $1.1M | 10.0K | 2.6K |
| 2022 | $104.54 | $72.65 | 1.44x | $31.89 | $1.2M | 11.5K | 2.7K |
| 2023 | $121.67 | $87.32 | 1.39x | $34.35 | $1.1M | 10.9K | 2.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 27.5K | $2.8M | $101.16 | 1.40x |
| 99443 | Physician telephone patient service, 21-30 minutes of medical discussion | 8.6K | $860.6K | $100.63 | 1.36x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 5.9K | $781.3K | $132.56 | 1.38x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 8.4K | $590.6K | $70.36 | 1.39x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.0K | $85.0K | $82.33 | 1.60x |
| 90662 | Vaccine for influenza for injection into muscle | 1.4K | $76.0K | $54.58 | 1.09x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 1.1K | $55.2K | $49.96 | 1.41x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 1.7K | $55.2K | $33.18 | 1.45x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 415 | $52.6K | $126.68 | 1.49x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 338 | $44.7K | $132.25 | 1.05x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 602 | $38.3K | $63.63 | 1.32x |
| 99350 | Established patient home visit, typically 60 minutes | 215 | $32.8K | $152.53 | 1.37x |
| G0008 | Administration of influenza virus vaccine | 1.4K | $32.0K | $22.77 | 1.37x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 179 | $31.5K | $175.71 | 1.49x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 425 | $27.2K | $64.02 | 1.38x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 1.5K | $24.7K | $16.88 | 1.45x |
| 99349 | Established patient home visit, typically 40 minutes | 164 | $16.9K | $103.22 | 1.45x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 72 | $15.7K | $218.27 | 1.30x |
| 64566 | Implantation of lower leg neurostimulator electrode, accessed through the skin | 121 | $13.7K | $113.60 | 1.32x |
| 99483 | Assessment of and care planning for patient with impaired thought processing, typically 60 minutes | 45 | $10.9K | $241.45 | 1.38x |
This provider submits charges 1.39 times higher than what Medicare actually pays.
A markup ratio of 1.39x means for every $100 Medicare pays, this provider initially charges $139. 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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