This provider averages 69 services per working day
Based on 69.2K total services over 4 years (250 working days/year). Learn about impossible service volumes →
This provider's $34.4M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Averaging 69 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 33935% from 2020 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 14615% in 2021
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 |
|---|---|---|---|---|---|---|---|
| 2020 | $180.37 | $84.37 | 2.14x | $96.00 | $33.8K | 401 | 3 |
| 2021 | $544.89 | $377.05 | 1.45x | $167.84 | $5.0M | 13.2K | 11 |
| 2022 | $650.85 | $476.89 | 1.36x | $173.96 | $17.8M | 37.4K | 15 |
| 2023 | $841.38 | $631.48 | 1.33x | $209.90 | $11.5M | 18.2K | 14 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4253 | Zenith amniotic membrane, per square centimeter | 24.2K | $17.0M | $703.82 | 1.31x |
| Q4262 | Dual layer impax membrane, per square centimeter | 7.5K | $7.7M | $1.0K | 1.28x |
| Q4247 | Amniotext patch, per square centimeter | 4.6K | $2.5M | $537.36 | 1.27x |
| Q4252 | Vendaje, per square centimeter | 1.2K | $2.0M | $1.6K | 1.27x |
| Q4162 | Woundex flow, bioskin flow, 0.5 cc | 898 | $1.5M | $1.7K | 1.49x |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 8.5K | $892.7K | $104.68 | 2.26x |
| Q4205 | Membrane graft or membrane wrap, per square centimeter | 3.2K | $878.8K | $271.92 | 1.47x |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 8.9K | $568.4K | $64.07 | 2.30x |
| Q4217 | Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter | 1.1K | $550.2K | $479.25 | 1.25x |
| 15271 | Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less | 1.7K | $204.3K | $122.61 | 2.53x |
| Q4188 | Amnioarmor, per square centimeter | 270 | $201.1K | $744.80 | 1.28x |
| 99342 | Residence visit for new patient with low level of medical decision making, per day, if using time, at least 30 minutes | 1.6K | $94.9K | $58.02 | 2.37x |
| 11000 | Removal of inflamed or infected skin, up to 10% of body surface | 1.7K | $65.9K | $38.21 | 2.82x |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 1.7K | $58.2K | $34.70 | 1.73x |
| 15275 | Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less | 278 | $35.4K | $127.23 | 2.52x |
| 11721 | Removal of fingernails or toenails, 6 or more nails | 648 | $21.1K | $32.51 | 2.72x |
| 15272 | Application of skin substitute graft to wound of trunk, arms, or legs, each additional 25.0 sq cm of wound 100.0 sq cm or less | 504 | $9.8K | $19.53 | 2.56x |
| 87641 | Detection test by nucleic acid for staphylococcus aureus, methicillin resistant (mrsa bacteria), amplified probe technique | 128 | $4.4K | $34.70 | 1.73x |
| 87500 | Detection test by nucleic acid for vancomycin resistance strep (vre), amplified probe technique | 125 | $4.3K | $34.71 | 1.73x |
| 87640 | Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique | 124 | $4.3K | $34.71 | 1.73x |
This provider submits charges 1.37 times higher than what Medicare actually pays.
A markup ratio of 1.37x means for every $100 Medicare pays, this provider initially charges $137. 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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