This provider averages 144 services per working day
Based on 360.2K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $10.2M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Averaging 144 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 199% from 2014 to 2023.
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 | $225.52 | $67.48 | 3.34x | $158.04 | $523.8K | 11.9K | 3.5K |
| 2015 | $230.25 | $63.78 | 3.61x | $166.47 | $533.0K | 19.9K | 4.1K |
| 2016 | $213.99 | $62.82 | 3.41x | $151.17 | $764.1K | 30.1K | 5.9K |
| 2017 | $139.67 | $43.74 | 3.19x | $95.93 | $855.4K | 38.9K | 6.4K |
| 2018 | $131.36 | $44.83 | 2.93x | $86.53 | $1.0M | 48.2K | 7.8K |
| 2019 | $145.29 | $48.46 | 3.00x | $96.83 | $1.1M | 43.5K | 5.7K |
| 2020 | $152.65 | $55.08 | 2.77x | $97.57 | $1.1M | 41.1K | 5.0K |
| 2021 | $160.41 | $57.71 | 2.78x | $102.70 | $1.3M | 46.9K | 7.3K |
| 2022 | $181.53 | $64.64 | 2.81x | $116.89 | $1.4M | 44.0K | 7.7K |
| 2023 | $194.63 | $64.12 | 3.04x | $130.51 | $1.6M | 35.9K | 7.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 32.2K | $2.0M | $62.70 | 3.27x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 11.7K | $1.1M | $92.85 | 2.86x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 15.0K | $997.4K | $66.57 | 2.92x |
| 95816 | Measurement and recording of brain wave (EEG) activity, awake and drowsy | 2.0K | $668.7K | $336.69 | 2.70x |
| J0600 | Injection, edetate calcium disodium, up to 1000 mg | 3.6K | $656.2K | $184.33 | 1.27x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 10.7K | $404.2K | $37.88 | 2.91x |
| P9020 | Platelet rich plasma, each unit | 1.6K | $389.1K | $242.29 | 1.27x |
| J3415 | Injection, pyridoxine hcl, 100 mg | 32.5K | $237.2K | $7.30 | 3.94x |
| 97535 | Self-care or home management training, each 15 minutes | 6.6K | $182.1K | $27.68 | 2.90x |
| 99358 | Prolonged patient service without direct patient contact first hour | 1.5K | $143.4K | $93.12 | 3.21x |
| J1955 | Injection, levocarnitine, per 1 gm | 7.6K | $138.0K | $18.25 | 2.56x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 3.3K | $130.0K | $39.93 | 4.54x |
| 97112 | Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 4.7K | $126.1K | $26.63 | 3.49x |
| 95957 | Digital analysis of electrical brain wave activity (EEG) | 476 | $123.5K | $259.37 | 2.89x |
| 27096 | Injection procedure into sacroiliac joint for anesthetic or steroid | 775 | $108.4K | $139.87 | 4.42x |
| 97129 | Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or sche | 4.9K | $94.6K | $19.50 | 3.38x |
| 97130 | Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or sche | 4.8K | $91.4K | $18.86 | 3.23x |
| 23430 | Anchoring of biceps tendon | 177 | $90.4K | $510.78 | 3.36x |
| 93925 | Ultrasound study of arteries and arterial grafts of both legs | 389 | $89.8K | $230.75 | 2.73x |
| 20553 | Injections of trigger points in 3 or more muscles | 1.8K | $86.8K | $48.64 | 3.39x |
This provider submits charges 3.19 times higher than what Medicare actually pays.
A markup ratio of 3.19x means for every $100 Medicare pays, this provider initially charges $319. 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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