This provider's $9.8M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 157613% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 3713% 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 | $241.40 | $84.52 | 2.86x | $156.88 | $2.6K | 31 | 1 |
| 2015 | $196.24 | $54.69 | 3.59x | $141.55 | $99.9K | 1.8K | 14 |
| 2016 | $110.96 | $29.40 | 3.77x | $81.56 | $117.6K | 4.0K | 12 |
| 2017 | $98.58 | $20.77 | 4.75x | $77.81 | $100.7K | 4.8K | 11 |
| 2018 | $333.74 | $63.34 | 5.27x | $270.40 | $47.7K | 753 | 6 |
| 2019 | $541.20 | $71.59 | 7.56x | $469.61 | $312.1K | 4.4K | 11 |
| 2020 | $222.23 | $80.44 | 2.76x | $141.79 | $517.2K | 6.4K | 12 |
| 2021 | $204.99 | $106.35 | 1.93x | $98.64 | $1.8M | 16.9K | 12 |
| 2022 | $247.56 | $124.34 | 1.99x | $123.22 | $2.7M | 21.5K | 8 |
| 2023 | $280.36 | $143.92 | 1.95x | $136.44 | $4.1M | 28.7K | 8 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 95816 | Measurement of brain wave activity (eeg), awake and drowsy | 14.6K | $5.2M | $353.97 | 1.97x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 19.1K | $1.4M | $75.75 | 2.17x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 5.7K | $586.7K | $103.09 | 2.41x |
| 95957 | Digital analysis of electrical brain wave activity (eeg) | 2.4K | $570.7K | $233.82 | 2.15x |
| 90901 | Biofeedback training | 15.5K | $565.4K | $36.56 | 2.03x |
| 97533 | Therapy procedure using sensory experiences | 4.7K | $248.0K | $52.53 | 1.91x |
| 96112 | Administration of developmental test, first hour | 2.0K | $216.7K | $111.07 | 2.53x |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 2.7K | $208.9K | $78.37 | 4.22x |
| 97129 | Therapy procedure for a range of mental processes, initial 15 minutes | 9.5K | $186.1K | $19.61 | 2.50x |
| 96132 | Evaluation of neuropsychological test, first hour | 1.2K | $130.3K | $108.87 | 2.04x |
| 95812 | Measurement of brain wave (eeg) activity, 41-60 minutes | 360 | $110.1K | $305.97 | 2.49x |
| 96116 | Exam of neurobehavioral status, first hour | 946 | $75.7K | $80.04 | 1.99x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 962 | $55.9K | $58.12 | 3.43x |
| 20610 | Aspiration and/or injection of fluid from large joint | 1.2K | $50.9K | $42.76 | 4.36x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 221 | $26.3K | $119.22 | 2.78x |
| 99483 | Assessment of and care planning for patient with impaired thought processing, typically 50 minutes | 110 | $24.4K | $222.19 | 4.01x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 173 | $22.3K | $128.89 | 3.11x |
| 95961 | Mapping of electrical brain wave activity (eeg) using electrodes on brain surface to provoke seizure activity or assess brain function, first hour | 64 | $18.5K | $289.60 | 1.79x |
| 97535 | Self-care or home management training, each 15 minutes | 624 | $17.2K | $27.53 | 2.98x |
| G0515 | Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes | 489 | $13.4K | $27.32 | 58.56x |
This provider submits charges 2.26 times higher than what Medicare actually pays.
A markup ratio of 2.26x means for every $100 Medicare pays, this provider initially charges $226. 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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