This provider averages 157 services per working day
Based on 313.2K total services over 8 years (250 working days/year). Learn about impossible service volumes →
Averaging 157 services per working day raises questions about billing patterns.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 54% 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 |
|---|---|---|---|---|---|---|---|
| 2016 | $2.4K | $680.31 | 3.46x | $1.7K | $20.8M | 30.5K | 26.0K |
| 2017 | $1.2K | $680.30 | 1.82x | $556.44 | $26.1M | 38.4K | 32.7K |
| 2018 | $1.6K | $680.31 | 2.40x | $949.27 | $20.9M | 30.8K | 26.2K |
| 2019 | $1.4K | $680.30 | 2.06x | $718.34 | $23.0M | 33.9K | 28.9K |
| 2020 | $1.5K | $680.31 | 2.25x | $848.37 | $35.6M | 52.3K | 44.6K |
| 2021 | $1.3K | $680.31 | 1.92x | $626.23 | $23.3M | 34.3K | 29.2K |
| 2022 | $2.6K | $680.30 | 3.89x | $2.0K | $32.4M | 47.7K | 40.6K |
| 2023 | $2.3K | $680.31 | 3.31x | $1.6K | $30.9M | 45.4K | 38.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office/outpatient visit, low complexity | 57.8K | $64.6M | $1.1K | 2.29x |
| 99214 | Office/outpatient visit, moderate complexity | 40.3K | $30.2M | $748.12 | 1.85x |
| 99215 | Office/outpatient visit, high complexity | 24.5K | $19.6M | $799.24 | 2.54x |
| 99203 | Office/outpatient visit, new patient | 13.1K | $12.8M | $983.43 | 2.76x |
| 36415 | Insertion of needle into vein for blood collection | 19.5K | $9.4M | $481.50 | 3.32x |
| 80053 | Comprehensive metabolic panel | 16.7K | $8.8M | $525.57 | 3.39x |
| 85025 | Complete blood cell count | 11.4K | $7.7M | $673.62 | 3.69x |
| 93000 | Electrocardiogram with interpretation | 13.9K | $6.9M | $496.09 | 3.60x |
| 71046 | Chest X-ray, 2 views | 11.8K | $5.4M | $458.24 | 3.28x |
| 96372 | Therapeutic injection | 8.4K | $5.1M | $602.88 | 2.78x |
This provider submits charges 2 times higher than what Medicare actually pays.
A markup ratio of 2x means for every $100 Medicare pays, this provider initially charges $200. This is lower 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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