This provider averages 65 services per working day
Based on 163.6K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $8.5M in total Medicare payments ranks in the 99th percentile of Infectious Disease providers nationally.
Averaging 65 services per working day raises questions about billing patterns.
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 | $163.94 | $57.49 | 2.85x | $106.45 | $819.3K | 16.3K | 3.6K |
| 2015 | $144.39 | $51.65 | 2.80x | $92.74 | $794.7K | 17.2K | 3.8K |
| 2016 | $144.98 | $52.30 | 2.77x | $92.68 | $915.6K | 19.2K | 4.1K |
| 2017 | $158.16 | $54.80 | 2.89x | $103.36 | $901.4K | 19.9K | 3.8K |
| 2018 | $153.58 | $56.59 | 2.71x | $96.99 | $901.0K | 18.1K | 3.9K |
| 2019 | $167.26 | $58.89 | 2.84x | $108.37 | $973.9K | 18.8K | 4.1K |
| 2020 | $167.60 | $56.72 | 2.95x | $110.88 | $814.9K | 14.9K | 3.2K |
| 2021 | $169.00 | $58.64 | 2.88x | $110.36 | $732.1K | 13.1K | 2.7K |
| 2022 | $183.31 | $67.14 | 2.73x | $116.17 | $748.3K | 13.0K | 2.7K |
| 2023 | $185.88 | $66.84 | 2.78x | $119.04 | $896.3K | 13.2K | 3.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 76.7K | $4.7M | $60.95 | 2.76x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 8.9K | $813.2K | $91.30 | 2.97x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.4K | $589.0K | $92.32 | 3.25x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.2K | $336.7K | $64.16 | 3.90x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.7K | $290.4K | $166.64 | 3.00x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 2.6K | $288.8K | $113.02 | 3.54x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 7.6K | $249.4K | $32.99 | 3.03x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 12.7K | $227.7K | $17.89 | 5.59x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 1.1K | $195.3K | $183.91 | 2.72x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 2.5K | $152.6K | $59.84 | 1.42x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 998 | $127.7K | $128.00 | 1.17x |
| J3490 | Unclassified drugs | 6.3K | $57.5K | $9.15 | 1.93x |
| G0181 | Physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of c | 578 | $52.7K | $91.19 | 2.56x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 368 | $44.0K | $119.51 | 2.93x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 621 | $43.0K | $69.22 | 2.17x |
| 90670 | Pneumococcal vaccine for injection into muscle | 181 | $35.2K | $194.21 | 1.20x |
| G0008 | Administration of influenza virus vaccine | 1.0K | $25.8K | $25.67 | 3.90x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 189 | $25.5K | $135.13 | 2.96x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 683 | $25.5K | $37.39 | 2.14x |
| 90662 | Vaccine for influenza for injection into muscle | 450 | $24.7K | $54.92 | 1.82x |
This provider submits charges 2.95 times higher than what Medicare actually pays.
A markup ratio of 2.95x means for every $100 Medicare pays, this provider initially charges $295. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
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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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