This provider's $3.5M in total Medicare payments ranks in the 99th percentile of Critical Care (Intensivists) providers nationally.
Medicare payments to this provider grew 2345% from 2015 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 756% in 2017
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 |
|---|---|---|---|---|---|---|---|
| 2015 | $693.50 | $115.97 | 5.98x | $577.53 | $21.3K | 193 | 176 |
| 2016 | $379.39 | $114.55 | 3.31x | $264.84 | $19.7K | 194 | 162 |
| 2017 | $441.67 | $98.07 | 4.50x | $343.60 | $168.6K | 1.5K | 901 |
| 2018 | $467.16 | $85.68 | 5.45x | $381.48 | $501.3K | 4.4K | 2.4K |
| 2019 | $487.96 | $90.36 | 5.40x | $397.60 | $472.6K | 3.9K | 2.5K |
| 2020 | $360.01 | $76.47 | 4.71x | $283.54 | $542.4K | 4.2K | 2.4K |
| 2021 | $363.14 | $83.39 | 4.35x | $279.75 | $677.8K | 5.8K | 3.2K |
| 2022 | $358.85 | $78.19 | 4.59x | $280.66 | $607.7K | 6.6K | 3.8K |
| 2023 | $350.70 | $74.12 | 4.73x | $276.58 | $519.8K | 6.0K | 3.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 7.4K | $1.4M | $192.42 | 4.89x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 6.4K | $574.9K | $89.72 | 5.79x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 5.6K | $377.2K | $67.63 | 2.96x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.1K | $186.5K | $164.71 | 3.25x |
| 99292 | Critical care delivery critically ill or injured patient | 1.6K | $155.9K | $97.07 | 3.62x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.0K | $152.5K | $146.50 | 2.63x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.6K | $100.0K | $61.69 | 3.86x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 874 | $87.1K | $99.63 | 2.87x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 670 | $76.5K | $114.14 | 2.42x |
| 31645 | Aspiration of lung secretions from lung airways using an endoscope | 476 | $53.5K | $112.48 | 5.73x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 206 | $36.9K | $179.07 | 2.26x |
| 31624 | Irrigation and suction of lung airways to obtain cells using an endoscope | 799 | $35.4K | $44.27 | 19.76x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 487 | $34.5K | $70.77 | 2.76x |
| 31500 | Emergent insertion of breathing tube into windpipe cartilage using an endoscope | 266 | $34.1K | $128.06 | 2.47x |
| 36556 | Insertion of central venous catheter for infusion, patient 5 years or older | 222 | $17.3K | $77.95 | 8.48x |
| 32555 | Removal of fluid from chest cavity with imaging guidance | 197 | $16.4K | $83.02 | 11.93x |
| 99457 | Management using the results of remote vital sign monitoring per calendar month, first 20 minutes | 381 | $15.4K | $40.34 | 3.72x |
| 94618 | Test for exercise-induced lung stress | 535 | $14.8K | $27.65 | 3.78x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 65 | $14.1K | $217.59 | 2.87x |
| 32557 | Removal of fluid from chest cavity with insertion of indwelling catheter and imaging guidance, accessed through the skin | 100 | $13.8K | $138.09 | 10.04x |
This provider submits charges 4.61 times higher than what Medicare actually pays.
A markup ratio of 4.61x means for every $100 Medicare pays, this provider initially charges $461. 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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