This provider's $4.6M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 497% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 211% in 2020
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 | $80.35 | $61.50 | 1.31x | $18.85 | $201.9K | 4.5K | 2.0K |
| 2015 | $89.04 | $63.34 | 1.41x | $25.70 | $227.5K | 4.7K | 2.2K |
| 2016 | $97.81 | $67.93 | 1.44x | $29.88 | $296.2K | 5.6K | 2.4K |
| 2017 | $88.58 | $52.75 | 1.68x | $35.83 | $304.9K | 5.7K | 2.3K |
| 2018 | $84.86 | $63.40 | 1.34x | $21.46 | $207.8K | 4.5K | 2.1K |
| 2019 | $78.35 | $60.42 | 1.30x | $17.93 | $229.8K | 4.6K | 2.3K |
| 2020 | $73.48 | $56.59 | 1.30x | $16.89 | $714.4K | 10.8K | 3.2K |
| 2021 | $82.77 | $64.81 | 1.28x | $17.96 | $749.7K | 10.9K | 3.2K |
| 2022 | $127.98 | $56.33 | 2.27x | $71.65 | $442.1K | 6.2K | 2.0K |
| 2023 | $139.55 | $94.68 | 1.47x | $44.87 | $1.2M | 13.4K | 2.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 17.0K | $1.5M | $89.72 | 1.28x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 15.9K | $1.0M | $65.08 | 1.29x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.7K | $519.9K | $90.58 | 1.69x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.9K | $303.5K | $62.56 | 1.52x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 1.1K | $169.8K | $158.13 | 1.29x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 1.2K | $160.2K | $136.47 | 1.14x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 955 | $144.9K | $151.73 | 1.57x |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 3.4K | $98.4K | $29.34 | 1.36x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 671 | $77.6K | $115.70 | 1.29x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 472 | $61.4K | $130.01 | 1.55x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 322 | $51.4K | $159.54 | 1.53x |
| 99316 | Nursing facility discharge management, more than 30 minutes | 429 | $47.2K | $110.04 | 1.27x |
| 94375 | Diagnostic testing in a pulmonary function lab | 1.4K | $43.1K | $31.45 | 1.55x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 404 | $36.9K | $91.25 | 1.36x |
| G0444 | Annual depression screening, 15 minutes | 1.3K | $28.1K | $20.91 | 1.48x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 2.0K | $26.2K | $13.40 | 1.64x |
| G0008 | Administration of influenza virus vaccine | 997 | $24.0K | $24.08 | 1.12x |
| 90670 | Pneumococcal vaccine for injection into muscle | 118 | $21.1K | $179.11 | 1.37x |
| 36415 | Insertion of needle into vein for collection of blood sample | 6.0K | $19.0K | $3.18 | 2.26x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 107 | $18.8K | $175.34 | 1.36x |
This provider submits charges 1.38 times higher than what Medicare actually pays.
A markup ratio of 1.38x means for every $100 Medicare pays, this provider initially charges $138. 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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