This provider's $3.2M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 323% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 104% in 2019
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 | $87.43 | $57.53 | 1.52x | $29.90 | $134.7K | 2.7K | 2.1K |
| 2015 | $97.38 | $59.47 | 1.64x | $37.91 | $159.1K | 2.6K | 2.1K |
| 2016 | $96.45 | $52.51 | 1.84x | $43.94 | $139.3K | 2.6K | 2.1K |
| 2017 | $95.25 | $56.22 | 1.69x | $39.03 | $174.6K | 3.0K | 2.6K |
| 2018 | $95.83 | $63.36 | 1.51x | $32.47 | $171.1K | 3.2K | 2.7K |
| 2019 | $80.17 | $49.47 | 1.62x | $30.70 | $349.7K | 6.5K | 5.6K |
| 2020 | $98.32 | $55.63 | 1.77x | $42.69 | $449.9K | 8.2K | 6.5K |
| 2021 | $99.10 | $61.10 | 1.62x | $38.00 | $527.7K | 7.7K | 6.0K |
| 2022 | $96.17 | $57.98 | 1.66x | $38.19 | $548.1K | 8.3K | 6.6K |
| 2023 | $92.29 | $55.81 | 1.65x | $36.48 | $569.8K | 8.9K | 7.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 7.7K | $940.4K | $122.07 | 1.37x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 13.7K | $724.2K | $52.92 | 1.67x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 7.6K | $600.8K | $78.69 | 1.66x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 689 | $113.6K | $164.91 | 1.12x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 3.0K | $91.3K | $29.95 | 1.90x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 395 | $85.3K | $215.91 | 1.62x |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 356 | $58.4K | $164.11 | 1.17x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 533 | $57.2K | $107.33 | 1.97x |
| G0008 | Administration of influenza virus vaccine | 2.7K | $51.1K | $18.81 | 1.08x |
| 90674 | Vaccine for influenza for administration into muscle, 0.5 ml dosage | 1.8K | $50.3K | $27.83 | 1.16x |
| 87636 | Sarscov2 & inf a&b amp prb | 332 | $46.7K | $140.55 | 1.42x |
| 90670 | Pneumococcal vaccine for injection into muscle | 267 | $44.8K | $167.66 | 1.13x |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | 852 | $36.8K | $43.18 | 1.05x |
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | 872 | $34.4K | $39.42 | 1.66x |
| G0444 | Annual depression screening, 15 minutes | 1.8K | $33.0K | $18.17 | 1.38x |
| 90732 | Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older | 357 | $31.2K | $87.46 | 1.05x |
| 99495 | Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge | 193 | $30.9K | $160.18 | 1.87x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 267 | $29.7K | $111.41 | 1.37x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 2.3K | $28.0K | $12.00 | 2.03x |
| 0241U | Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected | 114 | $15.8K | $138.70 | 1.44x |
This provider submits charges 1.56 times higher than what Medicare actually pays.
A markup ratio of 1.56x means for every $100 Medicare pays, this provider initially charges $156. 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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