This provider averages 60 services per working day
Based on 149.6K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $8.7M in total Medicare payments ranks in the 99th percentile of Pulmonary Disease providers nationally.
Their average markup ratio of 5.05x is significantly above the specialty median of 3.0x.
Averaging 60 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 77% 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 | $78.72 | $56.65 | 1.39x | $22.07 | $589.5K | 11.4K | 7.3K |
| 2015 | $269.50 | $53.53 | 5.03x | $215.97 | $710.8K | 12.3K | 8.2K |
| 2016 | $302.90 | $59.24 | 5.11x | $243.66 | $856.5K | 13.6K | 8.0K |
| 2017 | $332.63 | $67.22 | 4.95x | $265.41 | $897.6K | 14.7K | 8.2K |
| 2018 | $339.01 | $70.70 | 4.80x | $268.31 | $893.9K | 15.6K | 8.7K |
| 2019 | $336.08 | $70.55 | 4.76x | $265.53 | $910.3K | 16.1K | 9.0K |
| 2020 | $326.64 | $73.22 | 4.46x | $253.42 | $739.5K | 11.8K | 7.9K |
| 2021 | $321.96 | $78.03 | 4.13x | $243.93 | $984.9K | 15.4K | 9.5K |
| 2022 | $344.83 | $78.43 | 4.40x | $266.40 | $1.1M | 19.0K | 10.5K |
| 2023 | $285.40 | $61.44 | 4.65x | $223.96 | $1.0M | 19.7K | 11.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 38.9K | $4.0M | $102.29 | 4.98x |
| 94010 | Measurement and graphic recording of total and timed exhaled air capacity | 30.9K | $937.7K | $30.33 | 5.75x |
| 94729 | Measurement of lung diffusing capacity | 11.0K | $587.2K | $53.51 | 5.11x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 7.8K | $522.6K | $67.19 | 4.64x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.3K | $350.0K | $151.71 | 4.82x |
| 94727 | Determination of lung volumes using gas dilution or washout | 7.1K | $291.8K | $41.28 | 5.34x |
| 95012 | Measurement of inhaled nitric oxide gas | 14.3K | $267.0K | $18.61 | 5.70x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.6K | $240.3K | $93.41 | 4.92x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.6K | $227.5K | $63.33 | 2.97x |
| 94618 | Test for exercise-induced lung stress | 4.7K | $147.9K | $31.25 | 5.82x |
| 71046 | X-ray of chest, 2 views | 3.9K | $117.0K | $30.32 | 5.47x |
| 94060 | Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration | 2.1K | $115.3K | $55.36 | 5.76x |
| 94620 | Pulmonary exercise testing | 2.0K | $100.6K | $50.55 | 9.90x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 532 | $96.8K | $181.97 | 4.87x |
| 71020 | X-ray of chest, 2 views, front and side | 3.2K | $82.7K | $25.71 | 6.20x |
| 90662 | Vaccine for influenza for injection into muscle | 1.3K | $73.6K | $55.74 | 2.81x |
| 90670 | Pneumococcal vaccine for injection into muscle | 383 | $72.9K | $190.35 | 2.90x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 578 | $71.8K | $124.22 | 4.60x |
| G0008 | Administration of influenza virus vaccine | 1.8K | $48.2K | $26.39 | 3.91x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 2.9K | $45.7K | $16.05 | 7.16x |
This provider submits charges 5.05 times higher than what Medicare actually pays.
A markup ratio of 5.05x means for every $100 Medicare pays, this provider initially charges $505. 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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