This provider's $3.6M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 5033% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 480% in 2015
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 | $290.50 | $114.48 | 2.54x | $176.02 | $15.2K | 99 | 96 |
| 2015 | $309.25 | $119.16 | 2.60x | $190.09 | $88.1K | 655 | 553 |
| 2016 | $323.45 | $114.94 | 2.81x | $208.51 | $94.2K | 708 | 634 |
| 2017 | $494.08 | $125.82 | 3.93x | $368.26 | $122.6K | 764 | 708 |
| 2018 | $448.66 | $111.37 | 4.03x | $337.29 | $275.1K | 2.8K | 1.4K |
| 2019 | $480.91 | $110.09 | 4.37x | $370.82 | $390.4K | 4.2K | 2.3K |
| 2020 | $352.80 | $98.26 | 3.59x | $254.54 | $479.2K | 4.8K | 2.4K |
| 2021 | $288.59 | $97.19 | 2.97x | $191.40 | $760.2K | 8.2K | 3.8K |
| 2022 | $297.20 | $96.95 | 3.07x | $200.25 | $546.6K | 6.4K | 2.4K |
| 2023 | $166.26 | $86.75 | 1.92x | $79.51 | $779.1K | 10.1K | 3.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 5.4K | $909.3K | $168.83 | 3.46x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 7.7K | $708.4K | $91.59 | 4.87x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 5.1K | $319.4K | $62.54 | 5.74x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 5.0K | $303.2K | $60.57 | 2.98x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 3.2K | $269.2K | $85.07 | 1.75x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 768 | $144.2K | $187.77 | 2.30x |
| 99220 | Hospital observation care typically 70 minutes per day | 927 | $144.1K | $155.46 | 3.45x |
| 99239 | Hospital discharge day management, more than 30 minutes | 1.5K | $141.8K | $93.01 | 4.88x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 2.4K | $123.0K | $51.31 | 1.67x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 1.8K | $121.1K | $67.79 | 2.07x |
| 99439 | Chronic care management services, each additional 20 minutes of clinical staff time per calendar month | 2.4K | $94.1K | $39.94 | 1.71x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 510 | $57.1K | $112.06 | 3.30x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 325 | $47.9K | $147.45 | 2.59x |
| 99203 | New patient outpatient visit, total time 30-44 minutes | 324 | $40.1K | $123.61 | 2.98x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 380 | $32.0K | $84.11 | 2.67x |
| 99202 | New patient office or other outpatient visit, typically 20 minutes | 189 | $15.6K | $82.28 | 1.25x |
| 99219 | Hospital observation care typically 50 minutes | 120 | $13.5K | $112.34 | 3.65x |
| 99236 | Hospital observation or inpatient care high severity, 55 minutes per day | 55 | $10.1K | $183.09 | 3.58x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 60 | $9.9K | $165.82 | 2.33x |
| 99316 | Nursing facility discharge management, more than 30 minutes | 104 | $9.9K | $95.23 | 2.81x |
This provider submits charges 3.57 times higher than what Medicare actually pays.
A markup ratio of 3.57x means for every $100 Medicare pays, this provider initially charges $357. 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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