This provider's $5.6M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 68% from 2014 to 2023.
63% of their billing comes from a single procedure code (99350 — Established patient home visit, typically 60 minutes).
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 | $97.93 | $73.75 | 1.33x | $24.18 | $413.0K | 4.6K | 180 |
| 2015 | $108.60 | $80.86 | 1.34x | $27.74 | $370.8K | 4.2K | 211 |
| 2016 | $86.34 | $60.30 | 1.43x | $26.04 | $468.5K | 4.7K | 481 |
| 2017 | $116.91 | $81.98 | 1.43x | $34.93 | $504.0K | 4.5K | 377 |
| 2018 | $133.98 | $97.77 | 1.37x | $36.21 | $595.9K | 4.2K | 356 |
| 2019 | $149.74 | $101.62 | 1.47x | $48.12 | $642.9K | 4.5K | 422 |
| 2020 | $142.07 | $91.21 | 1.56x | $50.86 | $627.9K | 4.1K | 252 |
| 2021 | $115.11 | $79.62 | 1.45x | $35.49 | $662.2K | 4.4K | 533 |
| 2022 | $113.03 | $65.47 | 1.73x | $47.56 | $598.4K | 4.7K | 837 |
| 2023 | $123.56 | $76.83 | 1.61x | $46.73 | $692.3K | 5.2K | 600 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99350 | Established patient home visit, typically 60 minutes | 22.0K | $3.5M | $158.52 | 1.50x |
| 99349 | Established patient home visit, typically 40 minutes | 17.9K | $1.8M | $98.58 | 1.38x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.8K | $158.9K | $87.57 | 1.41x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 820 | $36.0K | $43.85 | 1.61x |
| 99345 | New patient home visit, typically 75 minutes | 152 | $22.2K | $145.83 | 1.49x |
| 99336 | Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes | 108 | $12.2K | $112.80 | 1.55x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 77 | $11.9K | $154.69 | 1.29x |
| 99439 | Chronic care management services, each additional 20 minutes of clinical staff time per calendar month | 212 | $8.7K | $41.09 | 1.70x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 551 | $7.7K | $13.97 | 2.19x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 137 | $7.2K | $52.68 | 1.56x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 139 | $6.9K | $49.83 | 2.04x |
| 99457 | Management using the results of remote vital sign monitoring per calendar month, first 20 minutes | 139 | $6.2K | $44.67 | 1.68x |
| 99334 | Established patient custodial care facility, group care, or assisted living visit, typically 15 minutes | 127 | $5.7K | $44.80 | 1.51x |
| 99335 | Established patient custodial care facility, group care, or assisted living visit, typically 25 minutes | 65 | $5.1K | $78.54 | 1.64x |
| 99496 | Transitional care management services for problem of high complexity | 26 | $5.1K | $196.10 | 1.27x |
| G0506 | Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) | 98 | $5.0K | $50.69 | 1.26x |
| G0181 | Physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of c | 53 | $4.9K | $93.27 | 1.41x |
| 99204 | New patient outpatient visit, total time 45-59 minutes | 53 | $4.9K | $91.63 | 1.79x |
| 99458 | Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes | 102 | $3.7K | $35.85 | 1.80x |
| G2058 | Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure). (do not report g2058 fo | 65 | $2.2K | $34.43 | 1.68x |
This provider submits charges 1.46 times higher than what Medicare actually pays.
A markup ratio of 1.46x means for every $100 Medicare pays, this provider initially charges $146. 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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