⚠️ This provider averages 307 services per working day — physically unusual for an individual practitioner
Based on 306.5K total services over 4 years (250 working days/year). Learn about impossible service volumes →
Averaging 307 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.
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 |
|---|---|---|---|---|---|---|---|
| 2020 | $882.57 | $350.69 | 2.52x | $531.88 | $22.8M | 65.0K | 147 |
| 2021 | $1.3K | $350.70 | 3.72x | $952.95 | $30.0M | 85.4K | 193 |
| 2022 | $847.58 | $350.69 | 2.42x | $496.89 | $28.6M | 81.7K | 184 |
| 2023 | $608.45 | $350.69 | 1.74x | $257.76 | $26.1M | 74.4K | 168 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office/outpatient visit, low complexity | 71.3K | $35.6M | $499.38 | 1.94x |
| 99214 | Office/outpatient visit, moderate complexity | 44.9K | $14.8M | $329.34 | 1.90x |
| 99215 | Office/outpatient visit, high complexity | 33.3K | $9.6M | $288.64 | 2.00x |
| 99203 | Office/outpatient visit, new patient | 14.2K | $6.4M | $445.94 | 2.08x |
| 80053 | Comprehensive metabolic panel | 11.9K | $5.0M | $421.20 | 3.84x |
| 93000 | Electrocardiogram with interpretation | 12.1K | $4.1M | $339.44 | 3.16x |
| 36415 | Insertion of needle into vein for blood collection | 9.5K | $3.3M | $353.55 | 2.80x |
| 71046 | Chest X-ray, 2 views | 8.4K | $3.0M | $359.07 | 3.95x |
| 96372 | Therapeutic injection | 4.5K | $2.2M | $488.86 | 3.01x |
| 85025 | Complete blood cell count | 3.8K | $2.0M | $516.18 | 3.69x |
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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