This provider averages 191 services per working day
Based on 476.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $29.8M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Averaging 191 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 1057% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 110% 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 | $213.79 | $67.71 | 3.16x | $146.08 | $768.3K | 11.3K | 12 |
| 2015 | $205.30 | $64.19 | 3.20x | $141.11 | $767.6K | 12.0K | 13 |
| 2016 | $204.71 | $58.91 | 3.47x | $145.80 | $1.6M | 27.3K | 19 |
| 2017 | $224.39 | $65.15 | 3.44x | $159.24 | $1.4M | 21.8K | 16 |
| 2018 | $225.38 | $63.23 | 3.56x | $162.15 | $2.2M | 34.0K | 22 |
| 2019 | $270.41 | $61.23 | 4.42x | $209.18 | $2.7M | 44.0K | 18 |
| 2020 | $290.98 | $61.75 | 4.71x | $229.23 | $2.3M | 37.2K | 15 |
| 2021 | $300.21 | $63.94 | 4.70x | $236.27 | $3.8M | 59.1K | 13 |
| 2022 | $297.86 | $61.02 | 4.88x | $236.84 | $5.4M | 88.7K | 14 |
| 2023 | $296.68 | $62.90 | 4.72x | $233.78 | $8.9M | 141.3K | 14 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31525 | Diagnostic exam of voice box using an endoscope | 98.7K | $13.0M | $131.50 | 3.62x |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | 48.0K | $5.1M | $106.93 | 2.32x |
| 31231 | Diagnostic exam of nasal passages using an endoscope | 122.7K | $3.9M | $31.59 | 11.98x |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 48.1K | $3.8M | $79.56 | 2.38x |
| 69210 | Removal of impacted ear wax | 122.8K | $1.7M | $13.65 | 7.03x |
| 99304 | Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 16.4K | $1.2M | $72.06 | 2.49x |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 13.2K | $764.8K | $57.77 | 2.50x |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 1.2K | $158.4K | $135.61 | 1.91x |
| 99307 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes | 1.8K | $61.7K | $33.91 | 2.64x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 651 | $56.3K | $86.44 | 2.11x |
| 92504 | Exam of ear using a microscope | 2.5K | $22.9K | $9.30 | 6.19x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 148 | $18.2K | $122.88 | 2.75x |
| 31535 | Biopsy of voice box using an endoscope | 90 | $14.3K | $158.80 | 2.46x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 106 | $10.1K | $94.85 | 2.70x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 30 | $4.2K | $141.10 | 1.42x |
| 99406 | Smoking and tobacco use intermediate counseling, greater than 3 minutes up to 10 minutes | 250 | $3.2K | $12.66 | 7.90x |
| G0436 | Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes | 46 | $594.29 | $12.92 | 7.74x |
| 30300 | Removal of foreign body in nose | 16 | $559.98 | $35.00 | 10.00x |
This provider submits charges 4.43 times higher than what Medicare actually pays.
A markup ratio of 4.43x means for every $100 Medicare pays, this provider initially charges $443. 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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