This provider's $4.5M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 422% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 120% in 2021
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 | $74.55 | $35.69 | 2.09x | $38.86 | $198.2K | 5.1K | 3.6K |
| 2015 | $78.53 | $38.07 | 2.06x | $40.46 | $169.9K | 3.8K | 3.0K |
| 2016 | $70.28 | $33.21 | 2.12x | $37.07 | $248.7K | 5.5K | 4.4K |
| 2017 | $78.08 | $37.43 | 2.09x | $40.65 | $344.9K | 7.6K | 6.1K |
| 2018 | $82.62 | $37.56 | 2.20x | $45.06 | $365.8K | 7.9K | 6.4K |
| 2019 | $90.21 | $44.70 | 2.02x | $45.51 | $472.2K | 9.3K | 7.0K |
| 2020 | $77.30 | $32.71 | 2.36x | $44.59 | $320.9K | 6.4K | 5.4K |
| 2021 | $87.28 | $43.68 | 2.00x | $43.60 | $706.3K | 12.2K | 10.4K |
| 2022 | $102.38 | $45.43 | 2.25x | $56.95 | $625.1K | 14.1K | 9.3K |
| 2023 | $88.64 | $42.68 | 2.08x | $45.96 | $1.0M | 24.5K | 7.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 11.3K | $1.0M | $88.78 | 1.84x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 23.6K | $612.5K | $26.01 | 4.18x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.9K | $518.3K | $65.35 | 2.10x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 6.2K | $497.4K | $80.04 | 1.96x |
| 87426 | Elisa detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 7.3K | $254.6K | $35.07 | 4.28x |
| 99202 | New patient office or other outpatient visit, typically 20 minutes | 3.1K | $244.7K | $79.59 | 2.06x |
| 87631 | Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 3-5 targets | 1.6K | $230.1K | $139.78 | 1.45x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.3K | $158.1K | $123.35 | 1.58x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 1.9K | $109.3K | $57.99 | 2.00x |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 1.8K | $92.8K | $51.20 | 2.90x |
| 90662 | Vaccine for influenza for injection into muscle | 1.8K | $83.5K | $46.31 | 1.22x |
| 87636 | Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19) and influenza virus types a and b | 517 | $72.2K | $139.70 | 1.16x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 4.1K | $70.5K | $17.05 | 2.44x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 411 | $54.0K | $131.40 | 1.24x |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 917 | $47.2K | $51.46 | 1.57x |
| G0008 | Administration of influenza virus vaccine | 1.8K | $46.4K | $25.11 | 1.44x |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | 884 | $45.3K | $51.30 | 3.09x |
| 87502 | Detection test by nucleic acid for multiple types influenza virus | 260 | $24.4K | $93.88 | 1.69x |
| 69210 | Removal of impact ear wax, one ear | 647 | $23.9K | $36.87 | 1.77x |
| 94640 | Respiratory inhaled pressure or nonpressure treatment to relieve airway obstruction or for sputum specimen | 1.3K | $18.7K | $14.66 | 2.44x |
This provider submits charges 2.38 times higher than what Medicare actually pays.
A markup ratio of 2.38x means for every $100 Medicare pays, this provider initially charges $238. 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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