⚠️ This provider averages 3.6K services per working day — physically unusual for an individual practitioner
Based on 4.5M total services over 5 years (250 working days/year). Learn about impossible service volumes →
Averaging 3.6K services per working day raises questions about billing patterns.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 78% in 2020
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 |
|---|---|---|---|---|---|---|---|
| 2019 | $92.66 | $37.55 | 2.47x | $55.11 | $23.8M | 633.9K | 297.8K |
| 2020 | $59.88 | $37.55 | 1.59x | $22.33 | $42.5M | 1.1M | 531.3K |
| 2021 | $81.89 | $37.55 | 2.18x | $44.34 | $35.9M | 954.7K | 448.6K |
| 2022 | $120.53 | $37.55 | 3.21x | $82.98 | $31.8M | 847.6K | 398.2K |
| 2023 | $75.01 | $37.55 | 2.00x | $37.46 | $34.4M | 916.1K | 430.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Office/outpatient visit, moderate complexity | 816.1K | $29.8M | $36.49 | 2.45x |
| 99213 | Office/outpatient visit, low complexity | 895.2K | $27.3M | $30.52 | 1.92x |
| 99215 | Office/outpatient visit, high complexity | 396.4K | $20.8M | $52.53 | 2.40x |
| 36415 | Insertion of needle into vein for blood collection | 279.7K | $13.6M | $48.63 | 3.00x |
| 80053 | Comprehensive metabolic panel | 196.2K | $8.7M | $44.22 | 3.78x |
| 71046 | Chest X-ray, 2 views | 300.6K | $8.2M | $27.27 | 3.41x |
| 93000 | Electrocardiogram with interpretation | 255.4K | $7.9M | $30.78 | 3.55x |
| 99203 | Office/outpatient visit, new patient | 213.4K | $7.4M | $34.60 | 2.50x |
| 85025 | Complete blood cell count | 191.0K | $7.1M | $37.35 | 3.93x |
| 96372 | Therapeutic injection | 97.2K | $3.9M | $40.25 | 2.41x |
This provider submits charges 2 times higher than what Medicare actually pays.
A markup ratio of 2x means for every $100 Medicare pays, this provider initially charges $200. This is lower than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
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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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