This provider's $4.0M in total Medicare payments ranks in the 99th percentile of Endocrinology 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 | $179.47 | $74.26 | 2.42x | $105.21 | $413.1K | 5.8K | 3.2K |
| 2015 | $195.04 | $74.37 | 2.62x | $120.67 | $407.4K | 5.8K | 3.3K |
| 2016 | $181.96 | $73.10 | 2.49x | $108.86 | $376.4K | 5.9K | 3.2K |
| 2017 | $174.13 | $63.64 | 2.74x | $110.49 | $331.1K | 5.5K | 2.8K |
| 2018 | $174.07 | $66.27 | 2.63x | $107.80 | $358.7K | 6.0K | 3.0K |
| 2019 | $174.06 | $71.47 | 2.44x | $102.59 | $391.2K | 6.7K | 3.2K |
| 2020 | $160.42 | $68.93 | 2.33x | $91.49 | $386.5K | 6.2K | 3.4K |
| 2021 | $154.68 | $67.50 | 2.29x | $87.18 | $439.4K | 6.4K | 3.3K |
| 2022 | $153.96 | $66.47 | 2.32x | $87.49 | $401.8K | 6.5K | 3.7K |
| 2023 | $180.39 | $73.48 | 2.45x | $106.91 | $507.3K | 7.3K | 4.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 19.2K | $1.6M | $83.55 | 2.18x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 4.2K | $474.0K | $113.70 | 2.30x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.7K | $328.9K | $57.71 | 2.14x |
| G0108 | Diabetes outpatient self-management training services, individual, per 30 minutes | 6.0K | $257.5K | $42.66 | 2.35x |
| 76536 | Ultrasound of head and neck | 2.5K | $218.8K | $86.08 | 2.11x |
| 95251 | Ambulatory continuous glucose (sugar) including interpretation and report for a minimum of 72 hours | 6.7K | $201.3K | $30.22 | 2.52x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 2.7K | $166.8K | $60.94 | 3.28x |
| 95250 | Ambulatory continuous glucose (sugar) monitoring for a minimum of 72 hours | 1.3K | $154.5K | $118.41 | 1.57x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.2K | $151.8K | $123.52 | 2.37x |
| 77080 | Bone density measurement using dedicated X-ray machine | 2.1K | $87.1K | $40.95 | 6.84x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 1.7K | $75.9K | $44.10 | 1.41x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 849 | $68.5K | $80.69 | 2.64x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 1.5K | $61.4K | $42.13 | 2.40x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 290 | $47.6K | $164.28 | 2.21x |
| J0897 | Injection, denosumab, 1 mg | 2.8K | $42.6K | $15.17 | 2.03x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 2.4K | $41.3K | $17.27 | 3.47x |
| 90670 | Pneumococcal vaccine for injection into muscle | 50 | $8.5K | $170.93 | 1.73x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 32 | $5.4K | $168.56 | 1.96x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 362 | $4.3K | $11.84 | 7.62x |
| 99457 | Remote physiologic monitoring treatment management services, health care professional time in a calendar month requiring interactive communication with the patient/caregiver; first 20 minutes | 79 | $3.3K | $42.09 | 1.29x |
This provider submits charges 2.36 times higher than what Medicare actually pays.
A markup ratio of 2.36x means for every $100 Medicare pays, this provider initially charges $236. 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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