This provider's $5.0M in total Medicare payments ranks in the 99th percentile of Geriatric Medicine 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 | $192.00 | $77.10 | 2.49x | $114.90 | $430.8K | 5.8K | 3.5K |
| 2015 | $190.44 | $75.69 | 2.52x | $114.75 | $501.3K | 6.5K | 3.9K |
| 2016 | $189.46 | $72.38 | 2.62x | $117.08 | $462.8K | 6.0K | 3.2K |
| 2017 | $200.26 | $74.51 | 2.69x | $125.75 | $457.8K | 6.2K | 3.6K |
| 2018 | $225.14 | $79.64 | 2.83x | $145.50 | $458.3K | 5.5K | 3.4K |
| 2019 | $234.45 | $85.37 | 2.75x | $149.08 | $500.6K | 5.6K | 3.1K |
| 2020 | $213.55 | $80.68 | 2.65x | $132.87 | $693.7K | 7.0K | 4.0K |
| 2021 | $217.68 | $86.71 | 2.51x | $130.97 | $522.5K | 5.8K | 3.6K |
| 2022 | $221.69 | $87.09 | 2.55x | $134.60 | $476.0K | 5.2K | 3.1K |
| 2023 | $216.85 | $85.13 | 2.55x | $131.72 | $496.6K | 5.5K | 3.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99336 | Established patient assisted living visit, typically 40 minutes | 10.5K | $1.1M | $107.32 | 2.19x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 2.7K | $444.2K | $162.42 | 1.85x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.9K | $424.1K | $86.16 | 2.18x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 5.1K | $376.5K | $74.43 | 2.01x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 2.4K | $335.1K | $139.17 | 2.55x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 938 | $196.3K | $209.28 | 2.50x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 2.6K | $196.3K | $75.95 | 2.27x |
| 99349 | Established patient home visit, typically 40 minutes | 1.5K | $150.6K | $100.50 | 2.98x |
| 99316 | Nursing facility discharge management, more than 30 minutes | 1.4K | $134.1K | $93.00 | 2.38x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 974 | $118.3K | $121.44 | 2.35x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 814 | $109.9K | $135.00 | 1.52x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.8K | $104.4K | $58.78 | 2.21x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.1K | $98.1K | $87.96 | 2.50x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.5K | $89.9K | $59.93 | 2.83x |
| 99350 | Established patient home visit, typically 60 minutes | 542 | $82.0K | $151.36 | 2.63x |
| G0181 | Physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of c | 827 | $72.1K | $87.23 | 2.99x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 1.2K | $63.3K | $52.11 | 2.40x |
| 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 | 1.4K | $61.6K | $44.59 | 2.50x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 537 | $60.9K | $113.43 | 1.98x |
| 99334 | Established patient assisted living visit, typically 15 minutes | 1.2K | $52.9K | $45.39 | 2.40x |
This provider submits charges 2.34 times higher than what Medicare actually pays.
A markup ratio of 2.34x means for every $100 Medicare pays, this provider initially charges $234. 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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