This provider's $3.7M in total Medicare payments ranks in the 99th percentile of Hospitalist providers nationally.
Medicare payments to this provider grew 840% from 2016 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 204% in 2019
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 |
|---|---|---|---|---|---|---|---|
| 2016 | $178.61 | $87.16 | 2.05x | $91.45 | $27.6K | 409 | 277 |
| 2017 | $192.30 | $78.64 | 2.45x | $113.66 | $76.4K | 1.2K | 717 |
| 2018 | $218.69 | $79.64 | 2.75x | $139.05 | $122.9K | 1.5K | 1.0K |
| 2019 | $164.02 | $87.18 | 1.88x | $76.84 | $373.4K | 4.3K | 2.1K |
| 2020 | $182.38 | $102.36 | 1.78x | $80.02 | $850.9K | 9.9K | 2.0K |
| 2021 | $214.34 | $91.55 | 2.34x | $122.79 | $918.0K | 9.5K | 2.2K |
| 2022 | $259.20 | $85.66 | 3.03x | $173.54 | $1.0M | 24.2K | 15.9K |
| 2023 | $257.50 | $67.08 | 3.84x | $190.42 | $259.2K | 9.5K | 8.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 6.0K | $1.2M | $192.80 | 1.70x |
| 80307 | Testing for presence of drug | 10.8K | $657.2K | $60.70 | 1.96x |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 3.2K | $489.6K | $153.05 | 1.63x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.3K | $329.6K | $77.54 | 2.73x |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 22.1K | $259.7K | $11.76 | 1.02x |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 579 | $140.4K | $242.49 | 1.61x |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 1.1K | $114.2K | $108.25 | 1.72x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 6.1K | $90.2K | $14.83 | 2.94x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.6K | $89.3K | $56.82 | 2.59x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 974 | $54.4K | $55.86 | 2.50x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 423 | $45.6K | $107.77 | 2.42x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 267 | $43.3K | $162.14 | 2.26x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 428 | $37.0K | $86.43 | 2.63x |
| 99239 | Hospital discharge day management, more than 30 minutes | 278 | $24.0K | $86.40 | 2.68x |
| 62370 | Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician | 329 | $22.8K | $69.24 | 5.14x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 95 | $17.3K | $182.48 | 3.67x |
| 99238 | Hospital discharge day management, 30 minutes or less | 269 | $14.9K | $55.40 | 2.53x |
| 99215 | Established patient outpatient visit, total time 40-54 minutes | 93 | $10.2K | $109.74 | 2.93x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 184 | $9.0K | $49.16 | 4.12x |
| 99220 | Hospital observation care typically 70 minutes per day | 52 | $7.4K | $142.42 | 2.20x |
This provider submits charges 1.94 times higher than what Medicare actually pays.
A markup ratio of 1.94x means for every $100 Medicare pays, this provider initially charges $194. 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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