This provider averages 51 services per working day
Based on 127.3K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $4.3M in total Medicare payments ranks in the 99th percentile of Infectious Disease providers nationally.
Averaging 51 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 62% from 2014 to 2023.
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 | $64.65 | $43.85 | 1.47x | $20.80 | $306.3K | 7.0K | 1.5K |
| 2015 | $87.07 | $46.99 | 1.85x | $40.08 | $331.1K | 6.9K | 1.6K |
| 2016 | $93.58 | $43.76 | 2.14x | $49.82 | $457.7K | 11.0K | 2.1K |
| 2017 | $115.99 | $49.89 | 2.32x | $66.10 | $499.3K | 12.6K | 2.4K |
| 2018 | $101.48 | $43.45 | 2.34x | $58.03 | $396.3K | 10.2K | 1.9K |
| 2019 | $119.91 | $48.20 | 2.49x | $71.71 | $459.8K | 11.6K | 2.0K |
| 2020 | $128.49 | $49.86 | 2.58x | $78.63 | $423.9K | 10.1K | 1.8K |
| 2021 | $121.49 | $48.06 | 2.53x | $73.43 | $458.1K | 15.6K | 2.2K |
| 2022 | $98.75 | $38.52 | 2.56x | $60.23 | $492.1K | 19.5K | 2.3K |
| 2023 | $101.10 | $38.91 | 2.60x | $62.19 | $495.2K | 22.6K | 2.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 24.4K | $1.3M | $52.03 | 2.75x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 15.4K | $870.6K | $56.35 | 2.65x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 3.3K | $507.8K | $156.23 | 2.37x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 4.9K | $390.3K | $80.43 | 2.32x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.2K | $344.6K | $82.49 | 1.85x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.4K | $339.9K | $62.43 | 1.79x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 5.7K | $131.4K | $22.99 | 2.80x |
| J1335 | Injection, ertapenem sodium, 500 mg | 3.2K | $75.8K | $23.33 | 4.75x |
| 96366 | Infusion into a vein for therapy, prevention, or diagnosis | 4.7K | $72.3K | $15.37 | 2.55x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 480 | $50.8K | $105.88 | 3.04x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 615 | $47.6K | $77.37 | 2.70x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 289 | $35.7K | $123.52 | 1.62x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 261 | $21.8K | $83.71 | 1.79x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 134 | $20.3K | $151.83 | 1.62x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 413 | $17.4K | $42.04 | 1.72x |
| J7060 | 5% dextrose/water (500 ml = 1 unit) | 11.2K | $16.1K | $1.43 | 7.46x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 927 | $14.9K | $16.07 | 1.87x |
| J3370 | Injection, vancomycin hcl, 500 mg | 5.2K | $12.3K | $2.39 | 4.02x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 365 | $11.2K | $30.72 | 3.26x |
| 36415 | Insertion of needle into vein for collection of blood sample | 2.9K | $10.6K | $3.65 | 1.50x |
This provider submits charges 2.57 times higher than what Medicare actually pays.
A markup ratio of 2.57x means for every $100 Medicare pays, this provider initially charges $257. 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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