This provider's $4.2M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 75% 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 | $184.52 | $98.28 | 1.88x | $86.24 | $320.3K | 3.7K | 1.5K |
| 2015 | $168.42 | $89.25 | 1.89x | $79.17 | $371.9K | 4.9K | 1.8K |
| 2016 | $165.30 | $88.88 | 1.86x | $76.42 | $451.7K | 5.8K | 2.3K |
| 2017 | $160.11 | $81.32 | 1.97x | $78.79 | $415.6K | 5.3K | 2.3K |
| 2018 | $151.28 | $78.01 | 1.94x | $73.27 | $360.5K | 5.3K | 2.2K |
| 2019 | $145.89 | $80.20 | 1.82x | $65.69 | $407.4K | 5.8K | 2.3K |
| 2020 | $125.79 | $72.62 | 1.73x | $53.17 | $371.3K | 5.4K | 2.5K |
| 2021 | $138.67 | $86.31 | 1.61x | $52.36 | $462.9K | 6.7K | 2.9K |
| 2022 | $140.75 | $83.28 | 1.69x | $57.47 | $511.4K | 7.5K | 2.8K |
| 2023 | $145.12 | $89.47 | 1.62x | $55.65 | $561.5K | 7.9K | 3.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 11.8K | $756.4K | $64.26 | 1.58x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 6.6K | $576.0K | $87.38 | 1.72x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 6.4K | $490.7K | $76.63 | 1.31x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 2.3K | $463.7K | $204.37 | 1.43x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 5.9K | $360.9K | $61.62 | 2.27x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 2.5K | $285.9K | $113.42 | 2.20x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 5.8K | $243.8K | $41.97 | 1.43x |
| 99239 | Hospital discharge day management, more than 30 minutes | 2.5K | $224.3K | $90.93 | 2.20x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 1.1K | $148.4K | $130.09 | 1.72x |
| 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 | 1.4K | $123.6K | $85.88 | 2.87x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 551 | $100.9K | $183.06 | 1.88x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 859 | $94.1K | $109.52 | 1.39x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 643 | $60.7K | $94.46 | 1.65x |
| 99483 | Assessment of and care planning for patient with impaired thought processing, typically 50 minutes | 202 | $49.2K | $243.44 | 1.44x |
| G0180 | Physician 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 imple | 811 | $36.0K | $44.33 | 2.02x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 259 | $35.9K | $138.51 | 1.80x |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 176 | $31.4K | $178.13 | 1.29x |
| 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 | 672 | $23.8K | $35.47 | 2.31x |
| G0444 | Annual depression screening, 15 minutes | 1.1K | $21.5K | $20.13 | 2.48x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 97 | $17.7K | $182.68 | 1.37x |
This provider submits charges 1.74 times higher than what Medicare actually pays.
A markup ratio of 1.74x means for every $100 Medicare pays, this provider initially charges $174. This is lower than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data