This provider averages 54 services per working day
Based on 133.8K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $9.8M in total Medicare payments ranks in the 99th percentile of Geriatric Medicine providers nationally.
Averaging 54 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 181% from 2014 to 2023.
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 | $154.06 | $85.10 | 1.81x | $68.96 | $449.3K | 6.2K | 2.7K |
| 2015 | $134.91 | $71.73 | 1.88x | $63.18 | $525.5K | 7.9K | 3.0K |
| 2016 | $130.93 | $72.47 | 1.81x | $58.46 | $677.1K | 9.9K | 3.9K |
| 2017 | $142.14 | $79.00 | 1.80x | $63.14 | $855.7K | 12.8K | 4.8K |
| 2018 | $139.85 | $76.29 | 1.83x | $63.56 | $865.6K | 12.2K | 4.9K |
| 2019 | $144.38 | $79.11 | 1.83x | $65.27 | $1.1M | 14.2K | 5.5K |
| 2020 | $147.06 | $82.43 | 1.78x | $64.63 | $1.1M | 15.3K | 7.1K |
| 2021 | $151.48 | $89.47 | 1.69x | $62.01 | $1.5M | 19.0K | 8.7K |
| 2022 | $220.73 | $138.99 | 1.59x | $81.74 | $1.6M | 20.2K | 9.5K |
| 2023 | $178.78 | $97.96 | 1.83x | $80.82 | $1.3M | 16.0K | 7.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 18.3K | $1.8M | $96.05 | 1.56x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 12.7K | $1.1M | $88.22 | 1.78x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 11.4K | $799.9K | $70.06 | 1.65x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 4.7K | $539.3K | $115.91 | 1.70x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 2.2K | $359.7K | $164.49 | 1.86x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 2.6K | $356.6K | $138.32 | 1.47x |
| 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 | 3.9K | $347.5K | $89.11 | 1.90x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 1.9K | $345.8K | $183.24 | 1.90x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 1.5K | $317.8K | $213.83 | 1.57x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 2.5K | $277.8K | $113.37 | 1.33x |
| 99350 | Established patient home visit, typically 60 minutes | 1.8K | $265.8K | $144.01 | 1.91x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 1.3K | $227.9K | $171.21 | 1.89x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 1.2K | $202.3K | $170.54 | 1.90x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 4.8K | $198.9K | $41.11 | 1.87x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 1.2K | $195.2K | $162.13 | 1.96x |
| 36410 | Insertion of needle into vein, patient 3 years or older | 12.0K | $172.9K | $14.43 | 1.76x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 2.8K | $172.9K | $62.30 | 1.77x |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | 3.2K | $160.6K | $50.92 | 1.37x |
| 99239 | Hospital discharge day management, more than 30 minutes | 1.7K | $157.4K | $90.85 | 2.01x |
| 99285 | Emergency department visit, problem with significant threat to life or function | 1.1K | $151.2K | $143.48 | 1.70x |
This provider submits charges 1.72 times higher than what Medicare actually pays.
A markup ratio of 1.72x means for every $100 Medicare pays, this provider initially charges $172. 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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