This provider's $4.1M in total Medicare payments ranks in the 99th percentile of Geriatric 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 58% 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 | $112.85 | $67.25 | 1.68x | $45.60 | $418.5K | 8.6K | 3.7K |
| 2015 | $96.95 | $58.63 | 1.65x | $38.32 | $407.6K | 8.5K | 3.5K |
| 2016 | $132.09 | $75.42 | 1.75x | $56.67 | $418.7K | 7.6K | 2.9K |
| 2017 | $149.13 | $78.96 | 1.89x | $70.17 | $446.2K | 7.4K | 3.6K |
| 2018 | $148.65 | $82.32 | 1.81x | $66.33 | $417.4K | 7.3K | 3.5K |
| 2019 | $143.11 | $79.35 | 1.80x | $63.76 | $468.5K | 7.6K | 3.6K |
| 2020 | $140.81 | $76.68 | 1.84x | $64.13 | $291.4K | 4.8K | 2.6K |
| 2021 | $127.97 | $73.20 | 1.75x | $54.77 | $461.8K | 8.5K | 4.3K |
| 2022 | $205.13 | $75.62 | 2.71x | $129.51 | $331.4K | 6.6K | 3.7K |
| 2023 | $246.69 | $78.23 | 3.15x | $168.46 | $431.7K | 7.8K | 4.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 27.4K | $1.6M | $57.72 | 2.42x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 8.2K | $497.0K | $60.93 | 1.95x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 3.4K | $451.6K | $134.41 | 1.86x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 3.3K | $299.4K | $89.56 | 2.14x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 746 | $124.7K | $167.19 | 2.08x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 1.5K | $120.1K | $77.53 | 1.86x |
| G0008 | Administration of influenza virus vaccine | 4.0K | $104.0K | $26.18 | 1.59x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 343 | $74.1K | $215.94 | 1.72x |
| 90670 | Pneumococcal vaccine for injection into muscle | 383 | $72.1K | $188.13 | 1.43x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.0K | $71.9K | $71.18 | 4.90x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 2.2K | $71.0K | $32.54 | 1.91x |
| G0444 | Annual depression screening, 15 minutes | 3.2K | $65.4K | $20.46 | 2.01x |
| 99239 | Hospital discharge day management, more than 30 minutes | 702 | $64.1K | $91.37 | 1.99x |
| 90732 | Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older | 619 | $59.6K | $96.35 | 1.31x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 244 | $44.8K | $183.59 | 2.54x |
| 90674 | Vaccine for influenza for administration into muscle, 0.5 ml dosage | 1.2K | $36.8K | $31.51 | 1.43x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 2.2K | $34.8K | $16.00 | 4.29x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 303 | $34.5K | $113.98 | 1.79x |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 172 | $30.6K | $177.95 | 1.44x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 208 | $29.3K | $140.99 | 1.87x |
This provider submits charges 2.2 times higher than what Medicare actually pays.
A markup ratio of 2.2x means for every $100 Medicare pays, this provider initially charges $220. 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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