This provider's $4.9M in total Medicare payments ranks in the 99th percentile of Undefined Physician type providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $241.32 | $78.71 | 3.07x | $162.61 | $411.5K | 6.5K | 3.4K |
| 2015 | $302.20 | $83.83 | 3.60x | $218.37 | $452.5K | 6.5K | 3.5K |
| 2016 | $321.34 | $87.82 | 3.66x | $233.52 | $478.7K | 7.2K | 3.8K |
| 2017 | $334.62 | $92.84 | 3.60x | $241.78 | $590.9K | 8.4K | 4.0K |
| 2018 | $335.65 | $95.21 | 3.53x | $240.44 | $585.8K | 8.0K | 4.1K |
| 2019 | $356.88 | $104.39 | 3.42x | $252.49 | $544.6K | 6.9K | 3.6K |
| 2020 | $375.22 | $119.80 | 3.13x | $255.42 | $438.6K | 5.0K | 2.8K |
| 2021 | $360.02 | $104.43 | 3.45x | $255.59 | $513.2K | 5.5K | 3.4K |
| 2022 | $359.77 | $100.16 | 3.59x | $259.61 | $518.6K | 5.7K | 3.4K |
| 2023 | $347.20 | $93.86 | 3.70x | $253.34 | $396.9K | 5.0K | 2.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 4.1K | $956.5K | $232.89 | 3.22x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 12.6K | $702.5K | $55.85 | 3.37x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 10.5K | $535.1K | $50.96 | 3.52x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.3K | $413.9K | $77.40 | 3.47x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 3.6K | $378.5K | $104.70 | 3.29x |
| 93975 | Ultrasound scan of abdominal, pelvic, and/or scrotal arterial inflow and venous outflow | 1.9K | $333.6K | $178.11 | 4.18x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 9.0K | $274.8K | $30.69 | 3.43x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 1.4K | $267.5K | $190.01 | 3.14x |
| 90966 | Home dialysis services per month, patient 20 years of age or older | 1.1K | $211.2K | $186.93 | 3.15x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.0K | $111.8K | $107.50 | 3.69x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.4K | $101.2K | $71.29 | 3.52x |
| 76770 | Ultrasound behind abdominal cavity | 1.8K | $86.4K | $48.81 | 7.01x |
| 90935 | Hemodialysis procedure with one physician evaluation | 1.5K | $83.8K | $56.52 | 2.98x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 890 | $71.5K | $80.30 | 3.33x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 410 | $63.9K | $155.96 | 3.26x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 365 | $51.2K | $140.31 | 3.03x |
| 99443 | Physician telephone patient service, 21-30 minutes of medical discussion | 587 | $49.7K | $84.63 | 3.54x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 229 | $46.2K | $201.90 | 3.17x |
| 99495 | Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge | 216 | $31.2K | $144.22 | 3.20x |
| 90945 | Dialysis procedure including one evaluation | 457 | $30.0K | $65.66 | 2.70x |
This provider submits charges 3.52 times higher than what Medicare actually pays.
A markup ratio of 3.52x means for every $100 Medicare pays, this provider initially charges $352. 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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