This provider's $6.2M in total Medicare payments ranks in the 99th percentile of Sleep Medicine providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 68% in 2018
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 | $437.62 | $126.15 | 3.47x | $311.47 | $457.7K | 2.7K | 1.7K |
| 2015 | $460.39 | $130.49 | 3.53x | $329.90 | $455.5K | 2.6K | 1.7K |
| 2016 | $422.51 | $121.50 | 3.48x | $301.01 | $503.3K | 2.7K | 1.9K |
| 2017 | $423.07 | $116.35 | 3.64x | $306.72 | $500.1K | 2.7K | 1.9K |
| 2018 | $429.99 | $124.50 | 3.45x | $305.49 | $838.9K | 4.0K | 2.8K |
| 2019 | $435.25 | $124.12 | 3.51x | $311.13 | $874.9K | 4.0K | 2.9K |
| 2020 | $499.00 | $136.08 | 3.67x | $362.92 | $560.4K | 2.7K | 2.0K |
| 2021 | $497.06 | $137.24 | 3.62x | $359.82 | $667.7K | 3.1K | 2.3K |
| 2022 | $497.62 | $140.38 | 3.54x | $357.24 | $661.6K | 3.2K | 2.3K |
| 2023 | $497.17 | $149.52 | 3.33x | $347.65 | $642.5K | 3.1K | 2.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 95810 | Sleep monitoring of patient (6 years or older) in sleep lab | 10.8K | $2.9M | $267.07 | 3.57x |
| 95811 | Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube | 9.1K | $2.5M | $270.18 | 3.54x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.0K | $239.7K | $78.99 | 1.90x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.2K | $175.8K | $78.61 | 3.12x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.2K | $163.2K | $51.67 | 2.42x |
| 95800 | Study of sleep patterns | 1.3K | $150.9K | $118.34 | 4.31x |
| 95806 | Unattended sleep study with recording of heart rate, oxygen, respiratory airflow and effort | 912 | $80.2K | $87.90 | 5.66x |
| 94690 | Collection and analysis of exhaled air for evaluation of lung function at rest | 101 | $3.8K | $37.18 | 3.23x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 101 | $1.6K | $15.88 | 3.46x |
| G0399 | Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation | 14 | $1.4K | $97.57 | 4.56x |
This provider submits charges 3.49 times higher than what Medicare actually pays.
A markup ratio of 3.49x means for every $100 Medicare pays, this provider initially charges $349. 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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