This provider averages 133 services per working day
Based on 333.2K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $31.1M in total Medicare payments ranks in the 99th percentile of Pulmonary Disease providers nationally.
Averaging 133 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 7940% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 2748% in 2019
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 | $232.54 | $77.13 | 3.01x | $155.41 | $111.2K | 1.4K | 11 |
| 2015 | $274.74 | $91.30 | 3.01x | $183.44 | $113.0K | 1.2K | 11 |
| 2016 | $295.14 | $94.97 | 3.11x | $200.17 | $121.3K | 1.3K | 15 |
| 2017 | $192.31 | $61.10 | 3.15x | $131.21 | $142.9K | 2.3K | 15 |
| 2018 | $196.65 | $63.81 | 3.08x | $132.84 | $157.6K | 2.5K | 20 |
| 2019 | $411.30 | $211.19 | 1.95x | $200.11 | $4.5M | 21.3K | 23 |
| 2020 | $136.82 | $70.06 | 1.95x | $66.76 | $5.9M | 84.5K | 23 |
| 2021 | $135.83 | $66.40 | 2.05x | $69.43 | $5.9M | 89.0K | 22 |
| 2022 | $135.08 | $71.43 | 1.89x | $63.65 | $5.2M | 72.3K | 22 |
| 2023 | $297.75 | $155.64 | 1.91x | $142.11 | $8.9M | 57.5K | 25 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0222 | Injection, patisiran, 0.1 mg | 249.2K | $18.5M | $74.31 | 1.84x |
| J0225 | Injection, vutrisiran, 1 mg | 1.9K | $5.9M | $3.1K | 1.75x |
| J3490 | Unclassified drugs | 766 | $3.1M | $4.1K | 1.85x |
| J2350 | Injection, ocrelizumab, 1 mg | 21.9K | $956.1K | $43.66 | 2.93x |
| J9312 | Injection, rituximab, 10 mg | 10.1K | $717.1K | $70.93 | 2.81x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 3.5K | $416.7K | $117.51 | 2.96x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 3.3K | $298.1K | $91.56 | 2.85x |
| J2182 | Injection, mepolizumab, 1 mg | 9.8K | $228.1K | $23.27 | 1.80x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 2.1K | $122.2K | $57.73 | 3.22x |
| Q5115 | Injection, rituximab-abbs, biosimilar, (truxima), 10 mg | 3.3K | $112.0K | $33.95 | 6.42x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 676 | $89.8K | $132.88 | 3.01x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 497 | $84.5K | $170.09 | 2.91x |
| 96401 | Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle | 1.1K | $70.2K | $64.49 | 3.12x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 597 | $64.4K | $107.91 | 3.30x |
| 99233 | Follow-up hospital inpatient care per day, typically 35 minutes | 623 | $51.9K | $83.39 | 2.93x |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 688 | $41.8K | $60.78 | 2.81x |
| 94729 | Test to examine how well the lungs exchange gases | 1.1K | $41.2K | $37.72 | 3.34x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 551 | $35.6K | $64.66 | 2.75x |
| 99223 | Initial hospital inpatient care per day, typically 70 minutes | 205 | $31.4K | $153.29 | 3.09x |
| J3489 | Injection, zoledronic acid, 1 mg | 4.0K | $29.1K | $7.24 | 18.87x |
This provider submits charges 1.97 times higher than what Medicare actually pays.
A markup ratio of 1.97x means for every $100 Medicare pays, this provider initially charges $197. 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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