This provider's $5.5M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 142% from 2014 to 2023.
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 | $219.15 | $84.67 | 2.59x | $134.48 | $349.8K | 4.7K | 1.9K |
| 2015 | $226.53 | $83.81 | 2.70x | $142.72 | $466.6K | 6.3K | 2.3K |
| 2016 | $241.62 | $87.79 | 2.75x | $153.83 | $423.6K | 6.1K | 1.9K |
| 2017 | $251.57 | $91.90 | 2.74x | $159.67 | $472.7K | 6.3K | 2.5K |
| 2018 | $242.70 | $88.07 | 2.76x | $154.63 | $484.3K | 6.5K | 2.7K |
| 2019 | $248.11 | $92.63 | 2.68x | $155.48 | $559.8K | 7.3K | 2.6K |
| 2020 | $208.56 | $78.95 | 2.64x | $129.61 | $583.3K | 8.3K | 2.8K |
| 2021 | $195.46 | $70.97 | 2.75x | $124.49 | $579.6K | 8.9K | 3.2K |
| 2022 | $210.40 | $76.16 | 2.76x | $134.24 | $691.0K | 9.8K | 4.2K |
| 2023 | $183.84 | $70.19 | 2.62x | $113.65 | $846.0K | 13.0K | 5.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 32.3K | $2.1M | $65.21 | 2.66x |
| 99487 | Complex chronic care management services 60 minutes clinical staff time | 13.2K | $1.0M | $75.76 | 1.98x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 4.1K | $501.3K | $123.12 | 2.59x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 4.7K | $470.9K | $100.79 | 2.57x |
| 99441 | Physician telephone patient service, 5-10 minutes of medical discussion | 6.7K | $274.3K | $41.17 | 1.45x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 2.2K | $212.7K | $95.32 | 2.71x |
| 99316 | Nursing facility discharge management, more than 30 minutes | 1.8K | $142.1K | $78.53 | 2.55x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 765 | $135.1K | $176.57 | 2.64x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 697 | $95.6K | $137.23 | 2.71x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 1.9K | $89.7K | $47.51 | 2.76x |
| 99443 | Physician telephone patient service, 21-30 minutes of medical discussion | 639 | $60.6K | $94.79 | 1.85x |
| 74240 | X-ray of upper digestive tract with single contrast | 571 | $43.8K | $76.69 | 3.91x |
| 74230 | Imaging for evaluation of swallowing function | 570 | $42.9K | $75.21 | 4.46x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 579 | $38.8K | $67.07 | 2.72x |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 293 | $34.4K | $117.34 | 3.03x |
| 92611 | Fluoroscopic and video recorded motion evaluation of swallowing function | 382 | $26.3K | $68.80 | 3.48x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 204 | $19.5K | $95.59 | 2.88x |
| 99491 | Chronic care management services by qualified health care professional, 30 minutes or more per calendar month | 315 | $18.6K | $58.94 | 2.55x |
| 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 | 395 | $15.4K | $39.11 | 2.99x |
| 99327 | New patient assisted living visit, typically 60 minutes | 104 | $14.1K | $135.69 | 2.65x |
This provider submits charges 2.5 times higher than what Medicare actually pays.
A markup ratio of 2.5x means for every $100 Medicare pays, this provider initially charges $250. This is higher 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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