This provider's $4.4M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 186% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 150% in 2023
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 | $100.30 | $52.72 | 1.90x | $47.58 | $398.3K | 7.8K | 5.5K |
| 2015 | $120.37 | $50.00 | 2.41x | $70.37 | $212.8K | 5.0K | 3.7K |
| 2016 | $147.40 | $56.76 | 2.60x | $90.64 | $280.2K | 5.8K | 4.8K |
| 2017 | $110.79 | $57.40 | 1.93x | $53.39 | $291.5K | 5.8K | 4.9K |
| 2018 | $122.99 | $63.81 | 1.93x | $59.18 | $415.3K | 7.7K | 6.0K |
| 2019 | $124.79 | $62.14 | 2.01x | $62.65 | $418.7K | 7.8K | 6.1K |
| 2020 | $116.01 | $57.59 | 2.01x | $58.42 | $405.5K | 7.2K | 5.6K |
| 2021 | $124.39 | $64.97 | 1.91x | $59.42 | $423.0K | 7.4K | 5.5K |
| 2022 | $101.51 | $59.58 | 1.70x | $41.93 | $455.7K | 9.6K | 5.6K |
| 2023 | $87.66 | $64.27 | 1.36x | $23.39 | $1.1M | 26.6K | 7.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 6.1K | $669.9K | $109.68 | 1.04x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 6.5K | $501.0K | $77.19 | 1.36x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 6.2K | $341.3K | $55.49 | 2.42x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.6K | $324.1K | $69.77 | 1.78x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.4K | $300.3K | $46.95 | 1.76x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 6.7K | $297.8K | $44.39 | 1.54x |
| 99457 | Management using the results of remote vital sign monitoring per calendar month, first 20 minutes | 4.2K | $144.2K | $34.56 | 1.51x |
| 99439 | Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month | 4.2K | $142.8K | $34.39 | 1.51x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 893 | $137.1K | $153.53 | 2.48x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 973 | $137.1K | $140.89 | 1.06x |
| 99484 | Care management services for behavioral health conditions, 20 minutes or more clinical staff time directed by health care professional | 3.7K | $116.3K | $31.20 | 1.49x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.3K | $108.6K | $81.43 | 2.31x |
| 90670 | Pneumococcal vaccine for injection into muscle | 548 | $98.3K | $179.39 | 1.46x |
| 99458 | Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes | 3.3K | $96.6K | $28.93 | 1.51x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 2.5K | $85.9K | $34.09 | 1.60x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 714 | $70.0K | $97.97 | 1.53x |
| 90662 | Vaccine for influenza for injection into muscle | 1.4K | $61.2K | $43.37 | 1.06x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 541 | $61.2K | $113.08 | 1.94x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 627 | $60.2K | $95.95 | 2.41x |
| 99487 | Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month | 453 | $43.9K | $96.87 | 1.56x |
This provider submits charges 1.69 times higher than what Medicare actually pays.
A markup ratio of 1.69x means for every $100 Medicare pays, this provider initially charges $169. This is lower 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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