This provider's $3.5M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 1390% from 2014 to 2023.
76% of their billing comes from a single procedure code (99310 — Subsequent nursing facility visit, typically 35 minutes per day).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 222% in 2017
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 | $190.08 | $71.42 | 2.66x | $118.66 | $60.4K | 1.3K | 376 |
| 2015 | $229.74 | $82.86 | 2.77x | $146.88 | $55.1K | 933 | 320 |
| 2016 | $199.87 | $87.63 | 2.28x | $112.24 | $55.2K | 538 | 245 |
| 2017 | $257.82 | $138.65 | 1.86x | $119.17 | $177.5K | 1.5K | 313 |
| 2018 | $226.99 | $137.16 | 1.65x | $89.83 | $338.0K | 2.9K | 400 |
| 2019 | $222.46 | $118.51 | 1.88x | $103.95 | $322.3K | 2.9K | 375 |
| 2020 | $223.43 | $134.59 | 1.66x | $88.84 | $391.7K | 3.3K | 440 |
| 2021 | $220.00 | $125.77 | 1.75x | $94.23 | $611.1K | 5.2K | 494 |
| 2022 | $220.00 | $123.68 | 1.78x | $96.32 | $574.0K | 5.0K | 457 |
| 2023 | $220.00 | $126.66 | 1.74x | $93.34 | $899.6K | 7.1K | 529 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 23.1K | $2.6M | $114.05 | 1.93x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 2.3K | $365.8K | $157.60 | 1.42x |
| 99350 | Established patient home visit, typically 60 minutes | 1.5K | $212.2K | $143.49 | 1.69x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 949 | $128.8K | $135.69 | 1.69x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 605 | $48.9K | $80.83 | 2.84x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 627 | $48.7K | $77.65 | 2.82x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 109 | $11.8K | $108.35 | 2.82x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 577 | $11.6K | $20.07 | 2.79x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 41 | $6.5K | $159.03 | 2.73x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 98 | $5.6K | $57.46 | 2.71x |
| 99328 | New patient assisted living visit, typically 75 minutes | 28 | $5.0K | $177.43 | 1.49x |
| G0008 | Administration of influenza virus vaccine | 31 | $847.85 | $27.35 | 2.05x |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | 577 | $642.92 | $1.11 | 2.65x |
| Q2038 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) | 31 | $365.80 | $11.80 | 1.10x |
This provider submits charges 1.89 times higher than what Medicare actually pays.
A markup ratio of 1.89x means for every $100 Medicare pays, this provider initially charges $189. 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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