This provider's $7.3M in total Medicare payments ranks in the 99th percentile of Infectious Disease providers nationally.
68% of their billing comes from a single procedure code (99232 — Subsequent hospital inpatient care, typically 25 minutes per day).
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 | $215.83 | $97.95 | 2.20x | $117.88 | $733.2K | 11.3K | 1.5K |
| 2015 | $244.85 | $100.82 | 2.43x | $144.03 | $653.5K | 10.0K | 1.3K |
| 2016 | $233.48 | $89.64 | 2.60x | $143.84 | $624.8K | 10.2K | 1.3K |
| 2017 | $262.80 | $97.89 | 2.68x | $164.91 | $708.4K | 12.0K | 1.5K |
| 2018 | $230.86 | $89.59 | 2.58x | $141.27 | $772.0K | 13.0K | 1.6K |
| 2019 | $230.43 | $90.27 | 2.55x | $140.16 | $645.1K | 10.7K | 1.7K |
| 2020 | $203.20 | $81.46 | 2.49x | $121.74 | $670.2K | 10.9K | 1.7K |
| 2021 | $203.20 | $82.52 | 2.46x | $120.68 | $878.2K | 15.0K | 1.8K |
| 2022 | $186.22 | $78.06 | 2.39x | $108.16 | $786.1K | 13.8K | 1.7K |
| 2023 | $143.50 | $58.68 | 2.45x | $84.82 | $830.2K | 14.6K | 1.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 88.6K | $5.0M | $56.08 | 2.47x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 16.1K | $849.1K | $52.89 | 2.84x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 4.8K | $506.9K | $104.55 | 2.59x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 2.7K | $420.9K | $153.32 | 2.45x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.0K | $162.1K | $79.60 | 2.37x |
| 96521 | Refilling and maintenance of portable pump | 951 | $93.6K | $98.44 | 2.44x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 1.2K | $85.2K | $68.48 | 2.92x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 1.4K | $67.7K | $49.56 | 3.23x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 834 | $66.6K | $79.84 | 1.93x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 310 | $31.1K | $100.23 | 2.99x |
| 96366 | Infusion into a vein for therapy, prevention, or diagnosis, each additional hour | 1.4K | $21.7K | $15.89 | 4.41x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 87 | $13.1K | $151.10 | 2.51x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 80 | $8.3K | $103.95 | 2.08x |
| 36589 | Removal of tunneled central venous tube | 39 | $4.9K | $124.70 | 1.52x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 17 | $2.1K | $123.49 | 3.04x |
| J3370 | Injection, vancomycin hcl, 500 mg | 427 | $845.23 | $1.98 | 9.09x |
| J2543 | Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) | 260 | $267.32 | $1.03 | 16.53x |
| J2185 | Injection, meropenem, 100 mg | 258 | $112.10 | $0.43 | 25.32x |
This provider submits charges 2.54 times higher than what Medicare actually pays.
A markup ratio of 2.54x means for every $100 Medicare pays, this provider initially charges $254. 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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