This provider's $4.8M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
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 |
|---|---|---|---|---|---|---|---|
| 2014 | $149.04 | $79.84 | 1.87x | $69.20 | $474.7K | 5.6K | 2.2K |
| 2015 | $166.46 | $87.75 | 1.90x | $78.71 | $533.2K | 6.0K | 2.3K |
| 2016 | $121.60 | $78.93 | 1.54x | $42.67 | $393.6K | 5.0K | 2.0K |
| 2017 | $117.91 | $79.60 | 1.48x | $38.31 | $396.9K | 4.8K | 2.1K |
| 2018 | $129.90 | $93.72 | 1.39x | $36.18 | $454.9K | 5.0K | 1.9K |
| 2019 | $105.76 | $72.89 | 1.45x | $32.87 | $473.1K | 5.5K | 2.3K |
| 2020 | $101.85 | $70.58 | 1.44x | $31.27 | $506.9K | 6.4K | 2.2K |
| 2021 | $116.03 | $84.21 | 1.38x | $31.82 | $501.7K | 5.0K | 2.0K |
| 2022 | $113.75 | $77.39 | 1.47x | $36.36 | $531.2K | 5.5K | 2.1K |
| 2023 | $115.10 | $75.30 | 1.53x | $39.80 | $488.9K | 4.8K | 1.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99349 | Established patient home visit, typically 40 minutes | 21.5K | $2.4M | $111.52 | 1.38x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 6.6K | $515.8K | $77.62 | 1.55x |
| 99345 | New patient home visit, typically 75 minutes | 2.0K | $397.3K | $195.64 | 1.38x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 5.4K | $345.1K | $63.87 | 1.44x |
| 99348 | Established patient home visit, typically 25 minutes | 3.4K | $245.5K | $73.23 | 1.37x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 1.1K | $211.0K | $198.48 | 1.94x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 949 | $115.3K | $121.48 | 1.36x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.3K | $92.0K | $69.44 | 1.50x |
| 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 im | 2.1K | $79.3K | $36.97 | 2.17x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 4.7K | $70.2K | $15.05 | 2.41x |
| 99495 | Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge | 333 | $51.2K | $153.65 | 1.31x |
| 99238 | Hospital discharge day management, 30 minutes or less | 736 | $47.4K | $64.40 | 1.33x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 501 | $46.1K | $91.92 | 1.39x |
| 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 imple | 650 | $31.2K | $47.95 | 2.08x |
| 99441 | Physician telephone patient service, 5-10 minutes of medical discussion | 603 | $28.8K | $47.70 | 2.10x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 105 | $18.8K | $179.52 | 2.79x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 196 | $17.9K | $91.54 | 2.75x |
| G0008 | Administration of influenza virus vaccine | 462 | $11.8K | $25.45 | 1.14x |
| 99239 | Hospital discharge day management, more than 30 minutes | 68 | $6.5K | $95.22 | 3.21x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 29 | $5.7K | $197.90 | 1.09x |
This provider submits charges 1.48 times higher than what Medicare actually pays.
A markup ratio of 1.48x means for every $100 Medicare pays, this provider initially charges $148. 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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