⚠️ This provider averages 346 services per working day — physically unusual for an individual practitioner
Based on 864.6K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $18.6M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Averaging 346 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 618% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 201% in 2015
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 | $85.99 | $47.13 | 1.82x | $38.86 | $269.6K | 7.4K | 6.0K |
| 2015 | $89.09 | $47.71 | 1.87x | $41.38 | $811.8K | 25.1K | 15.4K |
| 2016 | $83.27 | $48.63 | 1.71x | $34.64 | $1.4M | 40.0K | 24.1K |
| 2017 | $86.57 | $56.06 | 1.54x | $30.51 | $1.8M | 56.4K | 31.9K |
| 2018 | $81.19 | $47.35 | 1.71x | $33.84 | $2.4M | 107.0K | 57.6K |
| 2019 | $81.54 | $46.12 | 1.77x | $35.42 | $2.5M | 120.0K | 64.7K |
| 2020 | $83.60 | $48.29 | 1.73x | $35.31 | $2.5M | 130.0K | 70.3K |
| 2021 | $77.71 | $45.74 | 1.70x | $31.97 | $2.7M | 138.5K | 76.7K |
| 2022 | $75.26 | $42.34 | 1.78x | $32.92 | $2.3M | 130.5K | 75.2K |
| 2023 | $75.66 | $41.14 | 1.84x | $34.52 | $1.9M | 109.5K | 63.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 37.4K | $3.2M | $84.18 | 1.59x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 8.8K | $1.1M | $123.06 | 1.05x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 9.9K | $835.0K | $84.05 | 1.30x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 11.6K | $674.6K | $58.36 | 1.53x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 15.9K | $533.2K | $33.45 | 1.86x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 3.4K | $516.3K | $150.25 | 2.31x |
| 87633 | Detection test for multiple types of respiratory virus | 975 | $485.8K | $498.23 | 1.14x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 23.0K | $421.3K | $18.32 | 2.46x |
| 84481 | Thyroid hormone, T3 measurement | 22.0K | $401.0K | $18.22 | 1.92x |
| 82172 | Apolipoprotein level | 19.5K | $400.0K | $20.47 | 1.66x |
| 82607 | Cyanocobalamin (vitamin B-12) level | 20.6K | $340.1K | $16.50 | 2.00x |
| 82746 | Folic acid level | 20.4K | $329.0K | $16.11 | 1.99x |
| 83090 | Homocysteine (amino acid) level | 15.9K | $300.4K | $18.86 | 1.86x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 1.9K | $298.1K | $158.29 | 2.21x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.7K | $294.0K | $108.78 | 1.98x |
| G0446 | Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes | 10.8K | $285.0K | $26.51 | 1.13x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 20.7K | $278.4K | $13.42 | 2.16x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 30.7K | $259.0K | $8.44 | 2.96x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 1.4K | $245.7K | $172.91 | 1.03x |
| 83970 | Parathormone (parathyroid hormone) level | 4.7K | $231.1K | $49.09 | 1.63x |
This provider submits charges 1.7 times higher than what Medicare actually pays.
A markup ratio of 1.7x means for every $100 Medicare pays, this provider initially charges $170. This is lower 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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