This provider's $13.0M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 6594% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1922% 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 | $196.40 | $44.95 | 4.37x | $151.45 | $133.9K | 3.0K | 28 |
| 2015 | $245.31 | $45.61 | 5.38x | $199.70 | $187.9K | 4.1K | 28 |
| 2016 | $228.42 | $39.10 | 5.84x | $189.32 | $173.6K | 4.4K | 30 |
| 2017 | $213.54 | $36.08 | 5.92x | $177.46 | $134.3K | 3.7K | 26 |
| 2018 | $136.84 | $30.26 | 4.52x | $106.58 | $99.8K | 3.3K | 26 |
| 2019 | $156.92 | $36.02 | 4.36x | $120.90 | $153.0K | 4.2K | 32 |
| 2020 | $197.31 | $47.60 | 4.15x | $149.71 | $199.4K | 4.2K | 28 |
| 2021 | $169.60 | $41.19 | 4.12x | $128.41 | $141.0K | 3.4K | 24 |
| 2022 | $627.11 | $456.15 | 1.37x | $170.96 | $2.9M | 6.3K | 22 |
| 2023 | $1.1K | $833.48 | 1.35x | $292.65 | $9.0M | 10.8K | 13 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4217 | Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter | 6.5K | $6.3M | $970.10 | 1.28x |
| Q4236 | Carepatch, per square centimeter | 2.6K | $2.7M | $1.0K | 1.43x |
| Q4253 | Zenith amniotic membrane, per square centimeter | 2.4K | $1.9M | $767.14 | 1.28x |
| Q4205 | Membrane graft or membrane wrap, per square centimeter | 622 | $703.2K | $1.1K | 1.28x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 5.5K | $316.5K | $57.38 | 4.55x |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 1.2K | $149.0K | $122.93 | 5.25x |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 2.5K | $136.0K | $54.08 | 6.36x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 1.1K | $123.4K | $109.41 | 2.56x |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 2.0K | $104.2K | $50.96 | 2.71x |
| 11044 | Removal of bone, 20.0 sq cm or less | 494 | $89.4K | $181.06 | 4.05x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1.7K | $70.4K | $40.25 | 4.35x |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 918 | $61.3K | $66.80 | 3.04x |
| 99307 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes | 1.6K | $49.2K | $30.25 | 2.88x |
| 15271 | Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less | 357 | $36.9K | $103.32 | 3.96x |
| 99183 | Management and supervision of oxygen chamber therapy per session | 453 | $35.3K | $77.94 | 9.96x |
| 99304 | Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 488 | $31.6K | $64.67 | 2.64x |
| 11046 | Removal of muscle and/or tissue, each additional 20.0 sq cm or less | 626 | $30.1K | $48.13 | 2.91x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 182 | $28.2K | $154.91 | 2.71x |
| 11047 | Removal of skin and bone | 325 | $24.6K | $75.58 | 4.01x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 1.7K | $23.8K | $14.03 | 8.12x |
This provider submits charges 1.68 times higher than what Medicare actually pays.
A markup ratio of 1.68x means for every $100 Medicare pays, this provider initially charges $168. 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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