This provider's $4.1M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 284% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 115% in 2021
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 | $127.66 | $50.88 | 2.51x | $76.78 | $206.7K | 3.7K | 2.4K |
| 2015 | $138.10 | $61.93 | 2.23x | $76.17 | $262.6K | 4.5K | 3.0K |
| 2016 | $122.90 | $44.83 | 2.74x | $78.07 | $272.7K | 4.5K | 2.8K |
| 2017 | $142.60 | $55.58 | 2.57x | $87.02 | $392.2K | 6.9K | 4.5K |
| 2018 | $139.83 | $53.39 | 2.62x | $86.44 | $400.4K | 7.4K | 4.7K |
| 2019 | $157.69 | $59.54 | 2.65x | $98.15 | $271.2K | 5.7K | 4.2K |
| 2020 | $160.65 | $59.58 | 2.70x | $101.07 | $196.2K | 4.4K | 3.1K |
| 2021 | $160.95 | $65.54 | 2.46x | $95.41 | $421.4K | 8.5K | 6.6K |
| 2022 | $141.48 | $55.49 | 2.55x | $85.99 | $880.5K | 16.8K | 13.0K |
| 2023 | $132.69 | $58.80 | 2.26x | $73.89 | $793.1K | 17.8K | 14.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 15.1K | $934.7K | $61.72 | 3.64x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 3.0K | $387.3K | $130.67 | 1.92x |
| 87637 | Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19), influenza virus types a and b, and respiratory syncytial virus | 2.6K | $364.5K | $138.85 | 1.81x |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | 4.7K | $349.6K | $74.29 | 2.22x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.4K | $342.0K | $46.05 | 3.25x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.5K | $136.9K | $92.56 | 3.22x |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within | 4.7K | $116.4K | $24.76 | 2.20x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 3.3K | $114.9K | $34.73 | 2.72x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 453 | $96.5K | $213.03 | 2.30x |
| 90662 | Vaccine for influenza for injection into muscle | 1.8K | $95.4K | $52.82 | 1.42x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 468 | $70.6K | $150.88 | 3.10x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 386 | $68.5K | $177.51 | 2.07x |
| G0008 | Administration of influenza virus vaccine | 2.1K | $52.8K | $24.62 | 2.08x |
| G0442 | Annual alcohol misuse screening, 15 minutes | 2.6K | $50.9K | $19.84 | 1.98x |
| G0444 | Annual depression screening, 15 minutes | 2.3K | $45.3K | $19.72 | 1.99x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 392 | $43.0K | $109.57 | 3.18x |
| 99495 | Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge | 237 | $35.6K | $150.12 | 2.36x |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 990 | $34.1K | $34.40 | 1.55x |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 195 | $33.9K | $173.98 | 2.06x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 2.7K | $33.4K | $12.21 | 4.91x |
This provider submits charges 2.67 times higher than what Medicare actually pays.
A markup ratio of 2.67x means for every $100 Medicare pays, this provider initially charges $267. 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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