This provider's $3.6M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 19286% from 2014 to 2023.
75% of their billing comes from a single procedure code (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).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1655% 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 |
|---|---|---|---|---|---|---|---|
| 2014 | $72.59 | $28.73 | 2.53x | $43.86 | $6.2K | 144 | 117 |
| 2015 | $137.83 | $82.87 | 1.66x | $54.96 | $17.4K | 296 | 222 |
| 2016 | $168.34 | $61.88 | 2.72x | $106.46 | $6.3K | 110 | 45 |
| 2017 | $170.10 | $65.98 | 2.58x | $104.12 | $6.2K | 105 | 46 |
| 2018 | $159.01 | $47.93 | 3.32x | $111.08 | $6.8K | 141 | 46 |
| 2019 | $242.31 | $59.24 | 4.09x | $183.07 | $14.7K | 260 | 101 |
| 2020 | $134.17 | $76.85 | 1.75x | $57.32 | $257.2K | 3.1K | 2.0K |
| 2021 | $137.21 | $78.09 | 1.76x | $59.12 | $1.1M | 13.9K | 5.9K |
| 2022 | $136.27 | $75.71 | 1.80x | $60.56 | $1.0M | 13.5K | 6.5K |
| 2023 | $118.35 | $59.52 | 1.99x | $58.83 | $1.2M | 16.1K | 6.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 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 | 29.9K | $2.7M | $90.66 | 1.66x |
| 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 implem | 6.7K | $311.9K | $46.42 | 1.67x |
| G0179 | Physician re-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 imp | 6.5K | $236.9K | $36.59 | 1.67x |
| 99349 | Established patient home visit, typically 40 minutes | 749 | $82.5K | $110.17 | 1.66x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.4K | $73.4K | $50.80 | 3.26x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 360 | $51.4K | $142.67 | 1.31x |
| 99344 | New patient home visit, typically 60 minutes | 332 | $50.7K | $152.67 | 1.70x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 187 | $34.7K | $185.57 | 1.33x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 342 | $25.1K | $73.51 | 1.67x |
| G0108 | Diabetes outpatient self-management training services, individual, per 30 minutes | 328 | $16.1K | $48.96 | 1.65x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 123 | $8.5K | $69.36 | 2.09x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 98 | $7.7K | $78.25 | 2.55x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 137 | $3.8K | $28.08 | 4.57x |
| 99473 | Self-measured blood pressure; patient education/training and device calibration | 296 | $3.2K | $10.93 | 1.70x |
| 93886 | Ultrasound scanning of head and neck vessel blood flow (inside the brain) | 12 | $1.8K | $153.48 | 1.35x |
| 93923 | Ultrasound study of arteries of both arms and legs | 14 | $1.7K | $120.91 | 1.83x |
| 93965 | Ultrasound study of veins of both arms or legs including assessment of functional maneuvers | 15 | $1.3K | $86.77 | 1.74x |
| 99407 | Smoking and tobacco use intensive counseling, greater than 10 minutes | 41 | $1.3K | $31.44 | 1.31x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 55 | $683.47 | $12.43 | 3.81x |
| 36415 | Insertion of needle into vein for collection of blood sample | 69 | $335.16 | $4.86 | 3.09x |
This provider submits charges 1.69 times higher than what Medicare actually pays.
A markup ratio of 1.69x means for every $100 Medicare pays, this provider initially charges $169. 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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