This provider's $6.0M in total Medicare payments ranks in the 99th percentile of Infectious Disease providers nationally.
Medicare payments to this provider grew 57% 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 | $149.65 | $68.95 | 2.17x | $80.70 | $457.2K | 8.2K | 2.1K |
| 2015 | $121.84 | $56.27 | 2.17x | $65.57 | $483.4K | 8.0K | 2.2K |
| 2016 | $130.59 | $62.24 | 2.10x | $68.35 | $491.9K | 8.6K | 2.4K |
| 2017 | $129.90 | $61.38 | 2.12x | $68.52 | $580.3K | 11.4K | 2.5K |
| 2018 | $137.17 | $66.99 | 2.05x | $70.18 | $603.6K | 9.5K | 2.5K |
| 2019 | $123.82 | $52.96 | 2.34x | $70.86 | $591.3K | 11.8K | 2.6K |
| 2020 | $122.67 | $54.09 | 2.27x | $68.58 | $745.2K | 14.5K | 2.7K |
| 2021 | $139.09 | $62.56 | 2.22x | $76.53 | $615.8K | 11.5K | 2.6K |
| 2022 | $130.95 | $57.15 | 2.29x | $73.80 | $737.4K | 14.7K | 2.9K |
| 2023 | $125.89 | $48.38 | 2.60x | $77.51 | $717.7K | 15.1K | 2.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 29.8K | $1.7M | $58.02 | 2.59x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 15.8K | $1.4M | $88.75 | 2.30x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 5.8K | $983.2K | $168.22 | 1.93x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.8K | $658.5K | $96.99 | 2.08x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 8.1K | $495.7K | $60.97 | 1.91x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 926 | $128.3K | $138.55 | 1.88x |
| 96521 | Refilling and maintenance of portable pump | 1.1K | $119.6K | $109.36 | 2.74x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 4.1K | $104.4K | $25.19 | 1.98x |
| J1335 | Injection, ertapenem sodium, 500 mg | 3.6K | $94.9K | $26.44 | 2.65x |
| 96522 | Refilling and maintenance of implantable pump or reservoir for drug delivery | 847 | $85.7K | $101.13 | 2.37x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 317 | $58.5K | $184.55 | 1.63x |
| 96366 | Infusion into a vein for therapy, prevention, or diagnosis | 2.3K | $38.5K | $16.40 | 3.05x |
| 99220 | Hospital observation care typically 70 minutes per day | 192 | $30.0K | $156.38 | 1.92x |
| 97597 | Removal of tissue from wounds per session | 309 | $19.1K | $61.95 | 3.87x |
| 36415 | Insertion of needle into vein for collection of blood sample | 4.8K | $17.5K | $3.62 | 4.14x |
| G0180 | Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implem | 175 | $7.9K | $44.98 | 4.89x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 61 | $7.1K | $117.13 | 1.90x |
| 99495 | Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge | 48 | $7.0K | $146.63 | 2.59x |
| J3095 | Injection, telavancin, 10 mg | 1.3K | $6.7K | $5.15 | 7.32x |
| J0692 | Injection, cefepime hydrochloride, 500 mg | 3.0K | $4.5K | $1.54 | 9.76x |
This provider submits charges 2.32 times higher than what Medicare actually pays.
A markup ratio of 2.32x means for every $100 Medicare pays, this provider initially charges $232. 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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