This provider's $3.3M in total Medicare payments ranks in the 99th percentile of Geriatric Medicine providers nationally.
Medicare payments to this provider grew 30678% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1032% 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 | $55.50 | $26.24 | 2.12x | $29.26 | $1.9K | 48 | 48 |
| 2015 | $90.01 | $39.18 | 2.30x | $50.83 | $4.5K | 115 | 106 |
| 2016 | $127.27 | $53.77 | 2.37x | $73.50 | $50.4K | 780 | 637 |
| 2017 | $224.49 | $106.07 | 2.12x | $118.42 | $166.9K | 1.6K | 939 |
| 2018 | $257.44 | $106.77 | 2.41x | $150.67 | $411.4K | 4.3K | 1.8K |
| 2019 | $287.13 | $112.93 | 2.54x | $174.20 | $543.3K | 5.5K | 2.1K |
| 2020 | $247.77 | $101.40 | 2.44x | $146.37 | $422.4K | 5.8K | 2.1K |
| 2021 | $223.44 | $98.90 | 2.26x | $124.54 | $522.4K | 7.4K | 2.6K |
| 2022 | $226.04 | $97.73 | 2.31x | $128.31 | $590.7K | 8.0K | 3.0K |
| 2023 | $198.11 | $91.31 | 2.17x | $106.80 | $579.8K | 8.5K | 2.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99487 | Complex chronic care management services 60 minutes clinical staff time | 4.6K | $416.5K | $89.71 | 2.88x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 6.5K | $284.5K | $44.11 | 2.61x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 2.3K | $250.4K | $110.12 | 1.82x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.7K | $226.3K | $134.70 | 1.85x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.9K | $187.2K | $96.01 | 1.99x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 1.1K | $173.2K | $157.76 | 3.16x |
| 99489 | Complex chronic care management services each additional 30 minutes clinical staff time | 3.6K | $170.4K | $47.31 | 2.75x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 1.4K | $162.9K | $112.89 | 2.46x |
| 99483 | Assessment of and care planning for patient with impaired thought processing, typically 50 minutes | 603 | $128.9K | $213.84 | 3.15x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 1.5K | $116.2K | $76.91 | 2.37x |
| 99439 | Chronic care management services, each additional 20 minutes of clinical staff time per calendar month | 2.8K | $107.3K | $38.62 | 2.69x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 2.0K | $100.9K | $49.25 | 1.52x |
| 99349 | Established patient home visit, typically 40 minutes | 957 | $100.8K | $105.33 | 1.96x |
| 99457 | Remote physiologic monitoring treatment management services, health care professional time in a calendar month requiring interactive communication with the patient/caregiver; first 20 minutes | 2.3K | $99.8K | $42.66 | 2.81x |
| 99350 | Established patient home visit, typically 60 minutes | 558 | $80.4K | $144.03 | 1.50x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 563 | $78.6K | $139.52 | 1.27x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 488 | $78.4K | $160.56 | 2.62x |
| 99491 | Chronic care management services by qualified health care professional, 30 minutes or more per calendar month | 1.1K | $77.1K | $68.11 | 1.73x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.0K | $73.6K | $70.54 | 1.73x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 492 | $69.4K | $141.10 | 1.83x |
This provider submits charges 2.38 times higher than what Medicare actually pays.
A markup ratio of 2.38x means for every $100 Medicare pays, this provider initially charges $238. 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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