This provider's $5.2M in total Medicare payments ranks in the 99th percentile of Internal 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 | $169.37 | $96.73 | 1.75x | $72.64 | $438.9K | 4.0K | 1.6K |
| 2015 | $163.71 | $92.54 | 1.77x | $71.17 | $448.8K | 4.1K | 1.4K |
| 2016 | $164.44 | $95.16 | 1.73x | $69.28 | $446.9K | 3.7K | 1.1K |
| 2017 | $180.63 | $98.12 | 1.84x | $82.51 | $503.1K | 4.5K | 1.3K |
| 2018 | $168.35 | $92.44 | 1.82x | $75.91 | $496.0K | 4.2K | 1.4K |
| 2019 | $199.58 | $119.52 | 1.67x | $80.06 | $559.7K | 4.7K | 1.4K |
| 2020 | $199.29 | $118.72 | 1.68x | $80.57 | $524.8K | 4.5K | 1.2K |
| 2021 | $199.29 | $121.78 | 1.64x | $77.51 | $597.0K | 5.0K | 1.2K |
| 2022 | $199.29 | $120.40 | 1.66x | $78.89 | $531.7K | 4.5K | 1.2K |
| 2023 | $215.79 | $105.58 | 2.04x | $110.21 | $656.1K | 5.7K | 1.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99336 | Established patient assisted living visit, typically 40 minutes | 18.6K | $2.2M | $118.17 | 1.61x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 7.6K | $1.3M | $165.79 | 1.45x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 8.5K | $702.5K | $82.91 | 1.81x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 4.1K | $476.9K | $117.42 | 2.13x |
| 99328 | New patient assisted living visit, typically 75 minutes | 919 | $175.2K | $190.65 | 1.57x |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 545 | $93.5K | $171.64 | 2.04x |
| G0180 | Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple | 1.8K | $89.1K | $48.66 | 2.47x |
| 99327 | New patient assisted living visit, typically 60 minutes | 324 | $51.8K | $159.98 | 1.56x |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 589 | $40.8K | $69.32 | 2.88x |
| G0179 | Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp | 744 | $28.7K | $38.63 | 2.59x |
| 99345 | Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes | 137 | $25.6K | $186.60 | 1.47x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 227 | $16.6K | $73.29 | 2.39x |
| 99334 | Established patient assisted living visit, typically 15 minutes | 160 | $7.9K | $49.56 | 2.52x |
| G0008 | Administration of influenza virus vaccine | 218 | $6.4K | $29.23 | 1.75x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 101 | $6.4K | $63.08 | 2.38x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 31 | $5.2K | $168.96 | 1.33x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 46 | $4.2K | $91.87 | 1.90x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 33 | $3.7K | $112.96 | 1.55x |
| Q2037 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin) | 122 | $1.9K | $15.55 | 3.21x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 14 | $861.14 | $61.51 | 2.44x |
This provider submits charges 1.69 times higher than what Medicare actually pays.
A markup ratio of 1.69x means for every $100 Medicare pays, this provider initially charges $169. 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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