This provider's $3.9M in total Medicare payments ranks in the 99th percentile of Physician Assistant providers nationally.
Medicare payments to this provider grew 76% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 189% in 2018
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 | $145.10 | $64.58 | 2.25x | $80.52 | $285.7K | 4.9K | 1.4K |
| 2015 | $133.98 | $58.28 | 2.30x | $75.70 | $327.3K | 6.2K | 1.8K |
| 2016 | $136.32 | $51.75 | 2.63x | $84.57 | $300.2K | 6.0K | 1.5K |
| 2017 | $110.98 | $41.28 | 2.69x | $69.70 | $113.2K | 2.4K | 905 |
| 2018 | $132.99 | $55.08 | 2.41x | $77.91 | $326.9K | 5.8K | 2.1K |
| 2019 | $113.38 | $42.78 | 2.65x | $70.60 | $405.2K | 7.0K | 2.0K |
| 2020 | $93.58 | $42.17 | 2.22x | $51.41 | $533.5K | 8.0K | 2.5K |
| 2021 | $98.85 | $51.44 | 1.92x | $47.41 | $611.8K | 10.0K | 2.4K |
| 2022 | $98.77 | $49.40 | 2.00x | $49.37 | $460.4K | 9.1K | 2.7K |
| 2023 | $96.21 | $47.00 | 2.05x | $49.21 | $501.6K | 9.2K | 2.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 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 | 24.4K | $1.6M | $66.45 | 2.47x |
| 99350 | Established patient home visit, typically 60 minutes | 10.9K | $1.2M | $112.22 | 2.22x |
| 99349 | Established patient home visit, typically 40 minutes | 5.1K | $421.1K | $82.19 | 2.62x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 1.2K | $124.8K | $102.84 | 1.94x |
| 99345 | New patient home visit, typically 75 minutes | 974 | $123.0K | $126.30 | 2.63x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 6.2K | $77.0K | $12.36 | 2.61x |
| 99091 | Collection and interpretation of physical parameters stored in computers and/or transmitted by the patient and/or caregiver to qualified health care professional, requiring 30 minutes or more, per 30 days | 2.0K | $71.6K | $35.32 | 2.13x |
| G0008 | Administration of influenza virus vaccine | 2.5K | $58.7K | $23.18 | 1.38x |
| 90694 | Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | 346 | $19.3K | $55.90 | 1.12x |
| 99407 | Smoking and tobacco use intensive counseling, greater than 10 minutes | 832 | $19.1K | $23.01 | 1.43x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 101 | $14.2K | $140.66 | 1.78x |
| 90686 | Vaccine for influenza for administration into muscle, 0.5 ml dosage | 668 | $13.0K | $19.48 | 1.45x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 140 | $12.1K | $86.72 | 2.08x |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | 5.3K | $9.8K | $1.86 | 7.04x |
| 11043 | Removal of skin and/or muscle first 20 sq cm or less | 52 | $8.1K | $154.97 | 1.94x |
| 69210 | Removal of impact ear wax, one ear | 237 | $7.3K | $30.93 | 2.42x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 51 | $6.9K | $135.66 | 1.55x |
| Q2037 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin) | 433 | $6.8K | $15.69 | 1.59x |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 5.2K | $5.9K | $1.14 | 1.58x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 26 | $4.1K | $155.94 | 1.92x |
This provider submits charges 2.37 times higher than what Medicare actually pays.
A markup ratio of 2.37x means for every $100 Medicare pays, this provider initially charges $237. This is higher 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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