This provider's $5.1M 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.
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 | $111.68 | $67.63 | 1.65x | $44.05 | $626.1K | 9.3K | 3.1K |
| 2015 | $132.74 | $76.41 | 1.74x | $56.33 | $676.6K | 9.8K | 3.2K |
| 2016 | $131.93 | $78.21 | 1.69x | $53.72 | $615.7K | 9.0K | 2.9K |
| 2017 | $136.88 | $75.73 | 1.81x | $61.15 | $438.2K | 6.8K | 2.7K |
| 2018 | $160.41 | $85.58 | 1.87x | $74.83 | $438.0K | 6.3K | 2.6K |
| 2019 | $163.77 | $86.46 | 1.89x | $77.31 | $472.3K | 6.3K | 2.5K |
| 2020 | $153.34 | $80.78 | 1.90x | $72.56 | $382.5K | 5.0K | 2.1K |
| 2021 | $169.83 | $92.68 | 1.83x | $77.15 | $437.1K | 5.5K | 2.3K |
| 2022 | $161.52 | $83.52 | 1.93x | $78.00 | $470.1K | 6.1K | 2.4K |
| 2023 | $164.56 | $89.43 | 1.84x | $75.13 | $504.9K | 6.5K | 2.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 28.3K | $1.7M | $59.21 | 1.91x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 8.6K | $643.0K | $74.92 | 1.80x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 3.6K | $400.8K | $109.84 | 1.44x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.8K | $333.9K | $86.82 | 1.74x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 2.1K | $276.3K | $130.52 | 1.63x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 3.4K | $262.7K | $76.47 | 1.62x |
| 99349 | Established patient home visit, typically 40 minutes | 2.3K | $238.7K | $103.31 | 1.65x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 1.3K | $179.5K | $143.52 | 1.82x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.1K | $174.6K | $56.17 | 1.82x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 1.2K | $130.9K | $111.66 | 2.09x |
| 99348 | Established patient home visit, typically 25 minutes | 2.0K | $130.8K | $63.83 | 2.24x |
| 90662 | Vaccine for influenza for injection into muscle | 1.7K | $89.7K | $53.80 | 1.08x |
| 99316 | Nursing facility discharge management, more than 30 minutes | 709 | $64.7K | $91.27 | 1.72x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 1.6K | $59.0K | $37.26 | 2.12x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 367 | $44.6K | $121.44 | 1.94x |
| G0008 | Administration of influenza virus vaccine | 1.7K | $43.8K | $25.32 | 1.29x |
| 90670 | Pneumococcal vaccine for injection into muscle | 217 | $36.9K | $169.89 | 1.07x |
| 99344 | New patient home visit, typically 60 minutes | 270 | $35.3K | $130.71 | 2.49x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 532 | $32.0K | $60.21 | 1.71x |
| 99315 | Nursing facility discharge day management, 30 minutes or less | 493 | $31.8K | $64.60 | 2.30x |
This provider submits charges 1.79 times higher than what Medicare actually pays.
A markup ratio of 1.79x means for every $100 Medicare pays, this provider initially charges $179. 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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