This provider's $5.9M in total Medicare payments ranks in the 99th percentile of Infectious Disease 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 | $193.58 | $66.91 | 2.89x | $126.67 | $443.4K | 6.5K | 2.4K |
| 2015 | $179.02 | $58.37 | 3.07x | $120.65 | $564.0K | 9.1K | 2.5K |
| 2016 | $169.57 | $57.08 | 2.97x | $112.49 | $582.6K | 8.9K | 2.7K |
| 2017 | $178.24 | $62.93 | 2.83x | $115.31 | $644.4K | 9.8K | 2.8K |
| 2018 | $171.95 | $70.72 | 2.43x | $101.23 | $664.7K | 9.9K | 3.1K |
| 2019 | $157.17 | $61.81 | 2.54x | $95.36 | $605.7K | 9.7K | 2.7K |
| 2020 | $161.35 | $72.06 | 2.24x | $89.29 | $679.0K | 10.7K | 2.7K |
| 2021 | $127.80 | $60.07 | 2.13x | $67.73 | $570.9K | 9.0K | 2.7K |
| 2022 | $161.66 | $75.61 | 2.14x | $86.05 | $558.2K | 8.4K | 2.0K |
| 2023 | $146.75 | $58.40 | 2.51x | $88.35 | $616.2K | 9.3K | 2.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 52.1K | $2.9M | $56.08 | 2.09x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 7.6K | $776.0K | $102.05 | 2.06x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 8.5K | $709.9K | $83.43 | 2.11x |
| 96521 | Refilling and maintenance of portable pump | 5.4K | $544.6K | $100.37 | 3.66x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 3.3K | $505.9K | $152.57 | 2.42x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.1K | $119.7K | $55.80 | 2.03x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 992 | $118.1K | $119.01 | 2.30x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 1.5K | $77.1K | $50.76 | 4.43x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 855 | $66.8K | $78.14 | 2.57x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 1.0K | $33.9K | $33.26 | 1.95x |
| J3490 | Unclassified drugs | 575 | $23.3K | $40.45 | 5.65x |
| J3370 | Injection, vancomycin hcl, 500 mg | 4.4K | $10.5K | $2.38 | 19.95x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 107 | $8.4K | $78.70 | 2.09x |
| 0001A | Adm sarscov2 30mcg/0.3ml 1st | 255 | $5.3K | $20.70 | 1.46x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 198 | $3.1K | $15.74 | 2.90x |
| J0692 | Injection, cefepime hydrochloride, 500 mg | 826 | $1.6K | $1.95 | 22.99x |
| 99202 | New patient outpatient visit, total time 15-29 minutes | 44 | $1.6K | $36.50 | 3.75x |
| 0002A | Adm sarscov2 30mcg/0.3ml 2nd | 38 | $1.5K | $38.69 | 1.29x |
| G0008 | Administration of influenza virus vaccine | 43 | $1.0K | $23.69 | 1.27x |
| Q2039 | Influenza virus vaccine, not otherwise specified | 22 | $491.26 | $22.33 | 1.34x |
This provider submits charges 2.35 times higher than what Medicare actually pays.
A markup ratio of 2.35x means for every $100 Medicare pays, this provider initially charges $235. 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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