This provider's $4.9M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 302% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 182% 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 | $82.77 | $50.28 | 1.65x | $32.49 | $166.9K | 2.8K | 1.9K |
| 2015 | $86.77 | $53.30 | 1.63x | $33.47 | $470.1K | 8.7K | 4.1K |
| 2016 | $91.31 | $55.67 | 1.64x | $35.64 | $320.0K | 5.8K | 3.4K |
| 2017 | $99.44 | $61.68 | 1.61x | $37.76 | $287.2K | 4.3K | 2.9K |
| 2018 | $100.24 | $61.97 | 1.62x | $38.27 | $284.6K | 4.2K | 2.9K |
| 2019 | $96.90 | $55.96 | 1.73x | $40.94 | $552.8K | 11.6K | 5.2K |
| 2020 | $95.41 | $54.49 | 1.75x | $40.92 | $640.4K | 14.6K | 5.3K |
| 2021 | $94.90 | $54.95 | 1.73x | $39.95 | $748.4K | 16.1K | 5.4K |
| 2022 | $101.12 | $64.30 | 1.57x | $36.82 | $761.9K | 14.4K | 5.7K |
| 2023 | $106.64 | $66.49 | 1.60x | $40.15 | $670.7K | 12.2K | 5.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99490 | Chronic care management services at least 20 minutes per calendar month | 50.8K | $1.7M | $33.07 | 1.45x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 17.4K | $1.4M | $79.66 | 1.88x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 5.9K | $701.9K | $118.17 | 1.34x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 5.5K | $619.4K | $111.82 | 1.65x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.6K | $81.6K | $50.38 | 1.86x |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 222 | $61.5K | $277.00 | 1.08x |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 363 | $58.9K | $162.13 | 1.20x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 335 | $56.2K | $167.87 | 1.23x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 355 | $36.6K | $103.02 | 1.99x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 193 | $28.8K | $149.31 | 1.72x |
| G0008 | Administration of influenza virus vaccine | 1.1K | $25.2K | $22.35 | 1.79x |
| 90732 | Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older | 258 | $23.5K | $91.24 | 1.17x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 1.3K | $20.4K | $15.29 | 2.62x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 1.3K | $19.6K | $15.14 | 2.11x |
| 90756 | Vaccine for influenza for injection into muscle | 461 | $12.8K | $27.74 | 1.80x |
| G0009 | Administration of pneumococcal vaccine | 477 | $12.0K | $25.12 | 1.59x |
| 90686 | Vaccine for influenza administered into muscle to individuals 3 years of age and older | 604 | $10.9K | $18.08 | 2.53x |
| 83036 | Hemoglobin A1C level | 834 | $10.0K | $12.05 | 4.57x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 784 | $9.3K | $11.90 | 4.20x |
| 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 | 195 | $7.9K | $40.71 | 2.70x |
This provider submits charges 1.62 times higher than what Medicare actually pays.
A markup ratio of 1.62x means for every $100 Medicare pays, this provider initially charges $162. 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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