This provider's $5.2M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 76% in 2022
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 |
|---|---|---|---|---|---|---|---|
| 2014 | $191.10 | $77.79 | 2.46x | $113.31 | $500.5K | 7.1K | 2.0K |
| 2015 | $198.42 | $76.51 | 2.59x | $121.91 | $457.6K | 6.3K | 1.8K |
| 2016 | $198.52 | $73.84 | 2.69x | $124.68 | $481.6K | 6.7K | 2.0K |
| 2017 | $200.37 | $71.91 | 2.79x | $128.46 | $464.9K | 6.7K | 1.9K |
| 2018 | $218.23 | $83.68 | 2.61x | $134.55 | $440.8K | 5.9K | 1.7K |
| 2019 | $223.05 | $88.10 | 2.53x | $134.95 | $483.1K | 6.0K | 1.9K |
| 2020 | $220.71 | $91.57 | 2.41x | $129.14 | $482.8K | 5.7K | 1.7K |
| 2021 | $230.53 | $92.01 | 2.51x | $138.52 | $429.5K | 5.5K | 1.5K |
| 2022 | $218.25 | $86.34 | 2.53x | $131.91 | $757.2K | 9.9K | 2.3K |
| 2023 | $230.56 | $92.28 | 2.50x | $138.28 | $725.0K | 9.0K | 2.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 39.3K | $2.3M | $59.14 | 2.50x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 11.2K | $1.2M | $110.49 | 2.56x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 2.6K | $376.7K | $142.89 | 2.46x |
| 99349 | Established patient home visit, typically 40 minutes | 2.7K | $277.5K | $104.06 | 2.58x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 2.4K | $182.0K | $75.40 | 2.63x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 1.2K | $135.1K | $110.72 | 2.53x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.1K | $129.2K | $61.83 | 2.50x |
| 99316 | Nursing facility discharge management, more than 30 minutes | 1.3K | $125.5K | $95.40 | 2.35x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 862 | $82.2K | $95.38 | 2.40x |
| 99315 | Nursing facility discharge day management, 30 minutes or less | 1.3K | $81.9K | $61.43 | 2.46x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 688 | $54.3K | $78.87 | 2.53x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 173 | $27.9K | $161.49 | 2.54x |
| 99348 | Established patient home visit, typically 25 minutes | 405 | $26.1K | $64.54 | 2.87x |
| G0182 | Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patien | 199 | $17.8K | $89.35 | 2.57x |
| 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 imple | 347 | $16.0K | $46.02 | 2.62x |
| 99325 | New patient assisted living visit, typically 30 minutes | 252 | $16.0K | $63.33 | 2.89x |
| 99344 | New patient home visit, typically 60 minutes | 117 | $14.8K | $126.87 | 3.14x |
| 69210 | Removal of impact ear wax, one ear | 287 | $11.7K | $40.62 | 2.69x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 253 | $10.2K | $40.35 | 2.41x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 80 | $9.4K | $117.22 | 2.40x |
This provider submits charges 2.52 times higher than what Medicare actually pays.
A markup ratio of 2.52x means for every $100 Medicare pays, this provider initially charges $252. 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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