This provider's $4.3M in total Medicare payments ranks in the 99th percentile of Hospice and Palliative Care 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 | $209.55 | $70.76 | 2.96x | $138.79 | $390.5K | 5.4K | 2.7K |
| 2015 | $214.15 | $75.30 | 2.84x | $138.85 | $446.4K | 5.6K | 2.4K |
| 2016 | $204.14 | $80.93 | 2.52x | $123.21 | $414.6K | 5.0K | 2.5K |
| 2017 | $205.38 | $79.95 | 2.57x | $125.43 | $452.4K | 5.6K | 2.4K |
| 2018 | $190.00 | $72.62 | 2.62x | $117.38 | $447.5K | 5.7K | 2.5K |
| 2019 | $215.21 | $83.51 | 2.58x | $131.70 | $427.4K | 5.2K | 2.5K |
| 2020 | $197.92 | $78.07 | 2.54x | $119.85 | $469.9K | 5.4K | 2.2K |
| 2021 | $199.05 | $85.49 | 2.33x | $113.56 | $463.2K | 4.9K | 1.9K |
| 2022 | $163.74 | $75.02 | 2.18x | $88.72 | $378.8K | 4.5K | 1.6K |
| 2023 | $160.42 | $69.20 | 2.32x | $91.22 | $398.6K | 4.6K | 1.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 9.8K | $971.4K | $98.67 | 1.77x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 9.5K | $840.0K | $88.78 | 2.82x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 2.7K | $448.1K | $167.71 | 3.28x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.7K | $442.8K | $57.81 | 2.17x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 2.1K | $390.5K | $186.14 | 2.15x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 2.2K | $282.4K | $126.77 | 1.97x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 1.3K | $175.2K | $132.73 | 1.70x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 1.6K | $119.7K | $74.06 | 2.03x |
| 99238 | Hospital discharge day management, 30 minutes or less | 1.7K | $109.3K | $62.47 | 3.20x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 522 | $73.8K | $141.45 | 1.99x |
| 99239 | Hospital discharge day management, more than 30 minutes | 657 | $59.8K | $90.95 | 3.30x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 806 | $48.7K | $60.44 | 3.31x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 741 | $40.7K | $54.96 | 2.27x |
| 99220 | Hospital observation care typically 70 minutes per day | 259 | $40.2K | $155.02 | 2.58x |
| G0008 | Administration of influenza virus vaccine | 1.1K | $29.5K | $25.85 | 1.26x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 1.9K | $28.2K | $15.16 | 2.31x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 157 | $25.9K | $164.99 | 1.82x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 181 | $22.8K | $125.98 | 1.98x |
| 90674 | Vaccine for influenza for administration into muscle, 0.5 ml dosage | 697 | $20.3K | $29.13 | 1.20x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 1.6K | $20.3K | $12.78 | 6.65x |
This provider submits charges 2.4 times higher than what Medicare actually pays.
A markup ratio of 2.4x means for every $100 Medicare pays, this provider initially charges $240. This is higher 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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