This provider's $4.9M in total Medicare payments ranks in the 99th percentile of Internal 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 | $129.12 | $71.61 | 1.80x | $57.51 | $514.1K | 8.3K | 3.5K |
| 2015 | $137.78 | $72.93 | 1.89x | $64.85 | $495.5K | 7.9K | 3.3K |
| 2016 | $127.00 | $69.74 | 1.82x | $57.26 | $505.1K | 8.2K | 3.0K |
| 2017 | $121.88 | $71.24 | 1.71x | $50.64 | $450.6K | 7.3K | 2.5K |
| 2018 | $117.94 | $66.33 | 1.78x | $51.61 | $476.0K | 7.4K | 2.8K |
| 2019 | $125.87 | $70.26 | 1.79x | $55.61 | $495.9K | 7.7K | 2.8K |
| 2020 | $128.50 | $70.13 | 1.83x | $58.37 | $460.9K | 6.9K | 2.3K |
| 2021 | $126.94 | $75.14 | 1.69x | $51.80 | $515.0K | 6.9K | 2.3K |
| 2022 | $126.12 | $69.00 | 1.83x | $57.12 | $458.8K | 6.3K | 1.9K |
| 2023 | $123.66 | $57.93 | 2.13x | $65.73 | $484.5K | 5.9K | 2.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99335 | Established patient assisted living visit, typically 25 minutes | 25.8K | $1.9M | $74.85 | 2.00x |
| 99349 | Established patient home visit, typically 40 minutes | 10.4K | $1.1M | $102.36 | 1.71x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 15.1K | $881.5K | $58.51 | 1.58x |
| G0180 | Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple | 4.5K | $196.2K | $44.01 | 2.27x |
| 99327 | New patient assisted living visit, typically 60 minutes | 1.1K | $158.7K | $149.70 | 1.50x |
| G0008 | Administration of influenza virus vaccine | 4.3K | $106.3K | $24.66 | 1.35x |
| G0179 | Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial im | 2.7K | $91.7K | $34.09 | 2.93x |
| 90756 | Vaccine for influenza for injection into muscle | 2.2K | $60.1K | $27.24 | 2.08x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 819 | $55.7K | $68.01 | 1.47x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 388 | $43.9K | $113.10 | 2.21x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 779 | $43.7K | $56.08 | 1.78x |
| 99344 | New patient home visit, typically 60 minutes | 327 | $42.8K | $130.79 | 1.80x |
| 99239 | Hospital discharge day management, more than 30 minutes | 397 | $35.1K | $88.43 | 1.70x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 552 | $32.8K | $59.43 | 1.43x |
| Q2037 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin) | 2.0K | $31.6K | $15.84 | 1.95x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 317 | $28.9K | $91.04 | 1.75x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 644 | $8.7K | $13.43 | 3.72x |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 118 | $7.4K | $62.41 | 2.40x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 55 | $6.6K | $119.59 | 1.72x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 72 | $6.0K | $83.94 | 1.79x |
This provider submits charges 1.85 times higher than what Medicare actually pays.
A markup ratio of 1.85x means for every $100 Medicare pays, this provider initially charges $185. 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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