This provider's $3.7M 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.
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 | $159.49 | $113.94 | 1.40x | $45.55 | $372.1K | 4.3K | 1.9K |
| 2015 | $205.41 | $117.62 | 1.75x | $87.79 | $280.8K | 3.4K | 1.4K |
| 2016 | $232.73 | $92.49 | 2.52x | $140.24 | $350.5K | 4.6K | 1.4K |
| 2017 | $233.46 | $90.92 | 2.57x | $142.54 | $348.4K | 4.6K | 1.5K |
| 2018 | $233.12 | $90.97 | 2.56x | $142.15 | $345.9K | 4.3K | 1.7K |
| 2019 | $185.02 | $94.93 | 1.95x | $90.09 | $442.0K | 5.4K | 2.0K |
| 2020 | $183.32 | $93.75 | 1.96x | $89.57 | $345.5K | 4.2K | 1.7K |
| 2021 | $183.33 | $100.82 | 1.82x | $82.51 | $370.7K | 4.1K | 1.8K |
| 2022 | $183.33 | $97.37 | 1.88x | $85.96 | $390.2K | 4.6K | 1.7K |
| 2023 | $183.33 | $99.88 | 1.84x | $83.45 | $408.4K | 4.8K | 1.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 29.2K | $1.9M | $66.00 | 2.41x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 10.7K | $1.3M | $124.21 | 2.03x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.3K | $219.6K | $93.92 | 2.06x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 573 | $51.4K | $89.68 | 1.41x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 70 | $14.6K | $208.03 | 1.32x |
| 93925 | Ultrasound study of arteries and arterial grafts of both legs | 61 | $13.1K | $215.02 | 1.42x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 63 | $11.4K | $181.35 | 1.73x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 63 | $11.4K | $181.07 | 1.31x |
| 93970 | Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers | 61 | $10.9K | $179.24 | 1.30x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 124 | $8.1K | $64.92 | 1.30x |
| 93975 | Ultrasound scan of abdominal, pelvic, and/or scrotal arterial inflow and venous outflow | 30 | $7.9K | $262.02 | 1.50x |
| 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 | 73 | $6.3K | $85.90 | 1.44x |
| 93978 | Ultrasound scan of vena cava or groin graft or vessel blood flow | 29 | $6.1K | $210.98 | 1.29x |
| 76700 | Ultrasound of abdomen | 40 | $5.3K | $132.87 | 1.28x |
| 76770 | Ultrasound behind abdominal cavity | 42 | $5.3K | $125.30 | 1.28x |
| 93930 | Ultrasound study of arteries and arterial grafts of both arms | 26 | $5.3K | $202.13 | 1.38x |
| 76536 | Ultrasound of head and neck | 39 | $4.5K | $115.46 | 1.29x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 159 | $3.6K | $22.95 | 1.29x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 11 | $1.7K | $150.50 | 1.28x |
| G0179 | Physician re-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 im | 26 | $976.82 | $37.57 | 1.28x |
This provider submits charges 2.2 times higher than what Medicare actually pays.
A markup ratio of 2.2x means for every $100 Medicare pays, this provider initially charges $220. 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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