This provider's $3.7M in total Medicare payments ranks in the 99th percentile of Undefined Physician type providers nationally.
75% of their billing comes from a single procedure code (99232 — Subsequent hospital inpatient care, typically 25 minutes per day).
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 | $140.02 | $83.03 | 1.69x | $56.99 | $318.5K | 5.3K | 1.3K |
| 2015 | $139.30 | $82.41 | 1.69x | $56.89 | $360.1K | 6.1K | 1.4K |
| 2016 | $139.47 | $80.79 | 1.73x | $58.68 | $340.6K | 5.7K | 1.4K |
| 2017 | $146.46 | $81.77 | 1.79x | $64.69 | $333.8K | 5.6K | 1.4K |
| 2018 | $143.54 | $83.94 | 1.71x | $59.60 | $399.0K | 6.5K | 1.8K |
| 2019 | $127.15 | $63.30 | 2.01x | $63.85 | $394.0K | 6.9K | 1.5K |
| 2020 | $149.99 | $63.02 | 2.38x | $86.97 | $396.7K | 7.0K | 1.4K |
| 2021 | $160.00 | $62.62 | 2.56x | $97.38 | $383.6K | 6.6K | 1.4K |
| 2022 | $159.99 | $65.04 | 2.46x | $94.95 | $361.3K | 6.4K | 1.2K |
| 2023 | $150.00 | $62.27 | 2.41x | $87.73 | $430.3K | 7.1K | 1.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 52.2K | $2.8M | $53.41 | 2.18x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 6.2K | $615.8K | $98.79 | 1.88x |
| 99239 | Hospital discharge day management, more than 30 minutes | 2.4K | $189.3K | $77.92 | 1.98x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 1.6K | $47.3K | $30.22 | 2.89x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 240 | $35.8K | $149.07 | 1.73x |
| 99234 | Hospital observation or inpatient care low severity, 40 minutes per day | 159 | $15.4K | $97.01 | 1.51x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 197 | $15.1K | $76.83 | 1.62x |
| 99218 | Hospital observation care, typically 30 minutes | 40 | $2.9K | $71.61 | 1.96x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 40 | $2.7K | $68.69 | 2.26x |
| 99217 | Hospital observation care on day of discharge | 43 | $2.2K | $52.14 | 2.69x |
| 99238 | Hospital discharge day management, 30 minutes or less | 19 | $1.0K | $53.45 | 2.81x |
This provider submits charges 2.12 times higher than what Medicare actually pays.
A markup ratio of 2.12x means for every $100 Medicare pays, this provider initially charges $212. 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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