This provider's $6.0M in total Medicare payments ranks in the 99th percentile of Family Practice 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 | $102.47 | $49.67 | 2.06x | $52.80 | $767.6K | 15.1K | 6.4K |
| 2015 | $97.10 | $44.85 | 2.16x | $52.25 | $699.0K | 14.5K | 6.2K |
| 2016 | $99.09 | $46.05 | 2.15x | $53.04 | $762.7K | 16.1K | 6.3K |
| 2017 | $95.63 | $40.22 | 2.38x | $55.41 | $768.2K | 16.7K | 7.1K |
| 2018 | $93.74 | $41.80 | 2.24x | $51.94 | $784.7K | 15.9K | 6.5K |
| 2019 | $78.65 | $37.91 | 2.07x | $40.74 | $653.7K | 13.2K | 5.0K |
| 2020 | $96.34 | $47.16 | 2.04x | $49.18 | $482.0K | 8.7K | 3.1K |
| 2021 | $109.86 | $52.97 | 2.07x | $56.89 | $361.2K | 6.9K | 2.9K |
| 2022 | $85.37 | $40.44 | 2.11x | $44.93 | $332.4K | 7.0K | 2.6K |
| 2023 | $74.71 | $36.81 | 2.03x | $37.90 | $429.0K | 8.7K | 2.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 37.1K | $2.0M | $53.26 | 2.27x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 11.8K | $829.4K | $70.09 | 2.06x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 4.0K | $578.8K | $145.36 | 1.66x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 18.0K | $560.8K | $31.16 | 2.55x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 5.6K | $428.5K | $76.08 | 2.20x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 3.2K | $311.7K | $98.28 | 1.93x |
| 99238 | Hospital discharge day management, 30 minutes or less | 4.8K | $259.2K | $53.92 | 1.85x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.4K | $155.8K | $46.47 | 2.08x |
| 99350 | Established patient home visit, typically 60 minutes | 660 | $75.9K | $115.00 | 1.94x |
| 99220 | Hospital observation care, typically 70 minutes | 517 | $70.9K | $137.21 | 1.82x |
| 99239 | Hospital discharge day management, more than 30 minutes | 733 | $57.4K | $78.26 | 1.79x |
| 95943 | Testing of autonomic (parasympathetic and sympathetic) nervous system function | 353 | $47.7K | $135.02 | 1.95x |
| 93922 | Ultrasound study of arteries of both arms and legs | 782 | $44.2K | $56.46 | 3.06x |
| 95923 | Testing of autonomic (sympathetic) nervous system function | 366 | $40.7K | $111.11 | 2.38x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 2.6K | $37.5K | $14.53 | 2.22x |
| G0434 | Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter | 1.8K | $34.5K | $19.29 | 1.72x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 318 | $34.1K | $107.26 | 1.17x |
| 99217 | Hospital observation care on day of discharge | 613 | $32.7K | $53.29 | 2.35x |
| 80305 | Testing for presence of drug | 2.2K | $29.9K | $13.33 | 2.62x |
| 99226 | Subsequent observation care, typically 35 minutes per day | 353 | $27.3K | $77.24 | 1.94x |
This provider submits charges 2.16 times higher than what Medicare actually pays.
A markup ratio of 2.16x means for every $100 Medicare pays, this provider initially charges $216. 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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