This provider's $4.9M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 128% 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 | $68.49 | $38.47 | 1.78x | $30.02 | $296.3K | 7.7K | 5.3K |
| 2015 | $81.40 | $48.98 | 1.66x | $32.42 | $375.2K | 8.7K | 6.0K |
| 2016 | $82.51 | $47.75 | 1.73x | $34.76 | $383.5K | 9.1K | 6.5K |
| 2017 | $92.42 | $54.50 | 1.70x | $37.92 | $405.1K | 9.5K | 7.2K |
| 2018 | $92.79 | $57.20 | 1.62x | $35.59 | $460.1K | 10.6K | 8.0K |
| 2019 | $87.86 | $55.76 | 1.58x | $32.10 | $466.5K | 10.7K | 8.3K |
| 2020 | $93.60 | $60.60 | 1.54x | $33.00 | $520.1K | 11.6K | 9.1K |
| 2021 | $93.68 | $63.67 | 1.47x | $30.01 | $618.3K | 11.8K | 9.0K |
| 2022 | $99.43 | $67.18 | 1.48x | $32.25 | $683.2K | 12.2K | 9.2K |
| 2023 | $97.79 | $66.25 | 1.48x | $31.54 | $675.6K | 12.3K | 9.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 19.3K | $1.2M | $63.94 | 1.57x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 6.3K | $884.1K | $141.30 | 1.56x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.7K | $568.1K | $99.31 | 1.56x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 5.4K | $234.2K | $43.20 | 1.51x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 1.1K | $221.1K | $194.13 | 1.29x |
| G0446 | Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes | 6.4K | $193.1K | $30.39 | 1.97x |
| 90682 | Vaccine for influenza for injection into muscle | 2.6K | $157.0K | $60.56 | 1.40x |
| G0008 | Administration of influenza virus vaccine | 5.5K | $148.0K | $26.84 | 1.38x |
| 90670 | Pneumococcal vaccine for injection into muscle | 784 | $143.7K | $183.31 | 1.26x |
| 76775 | Ultrasound behind abdominal cavity, limited | 2.7K | $136.2K | $49.71 | 3.32x |
| G0444 | Annual depression screening, 15 minutes | 5.6K | $119.5K | $21.54 | 2.79x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 8.2K | $110.5K | $13.46 | 2.99x |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 264 | $73.7K | $279.27 | 1.28x |
| 90732 | Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older | 591 | $62.9K | $106.39 | 1.11x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 632 | $55.2K | $87.41 | 1.62x |
| 36415 | Insertion of needle into vein for collection of blood sample | 14.4K | $52.9K | $3.68 | 4.06x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 2.7K | $52.1K | $19.24 | 2.04x |
| G0009 | Administration of pneumococcal vaccine | 1.6K | $44.8K | $27.29 | 1.49x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 184 | $43.7K | $237.39 | 1.36x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 274 | $39.4K | $143.67 | 1.43x |
This provider submits charges 1.69 times higher than what Medicare actually pays.
A markup ratio of 1.69x means for every $100 Medicare pays, this provider initially charges $169. 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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