This provider's $3.8M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 559% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 85% in 2017
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 | $125.83 | $35.91 | 3.50x | $89.92 | $172.2K | 6.0K | 4.1K |
| 2015 | $88.04 | $26.37 | 3.34x | $61.67 | $136.9K | 5.9K | 3.6K |
| 2016 | $62.29 | $21.27 | 2.93x | $41.02 | $102.8K | 4.7K | 3.0K |
| 2017 | $73.76 | $27.30 | 2.70x | $46.46 | $190.4K | 6.7K | 4.5K |
| 2018 | $76.33 | $39.00 | 1.96x | $37.33 | $223.3K | 5.4K | 4.1K |
| 2019 | $73.00 | $36.67 | 1.99x | $36.33 | $298.5K | 9.1K | 6.1K |
| 2020 | $74.94 | $36.44 | 2.06x | $38.50 | $338.2K | 10.2K | 6.2K |
| 2021 | $80.45 | $42.91 | 1.87x | $37.54 | $504.3K | 12.4K | 8.1K |
| 2022 | $88.17 | $41.99 | 2.10x | $46.18 | $743.2K | 21.9K | 15.2K |
| 2023 | $96.16 | $43.98 | 2.19x | $52.18 | $1.1M | 35.3K | 22.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 16.9K | $1.2M | $73.92 | 2.08x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 2.7K | $299.7K | $110.70 | 1.15x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.2K | $293.0K | $56.35 | 1.87x |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 627 | $170.3K | $271.67 | 1.17x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 5.0K | $164.6K | $32.76 | 1.92x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.1K | $110.1K | $101.93 | 2.22x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 1.4K | $107.3K | $76.06 | 1.41x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 6.7K | $86.7K | $12.95 | 3.07x |
| 90662 | Vaccine for influenza for injection into muscle | 1.4K | $83.7K | $57.74 | 1.17x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.1K | $69.9K | $65.97 | 2.33x |
| 36415 | Insertion of needle into vein for collection of blood sample | 13.6K | $58.0K | $4.27 | 7.12x |
| 80053 | Blood test, comprehensive group of blood chemicals | 5.0K | $54.1K | $10.94 | 5.52x |
| M0243 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring | 141 | $51.4K | $364.32 | 1.36x |
| 83036 | Hemoglobin A1C level | 4.7K | $48.0K | $10.16 | 3.83x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 2.7K | $46.8K | $17.53 | 4.09x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 5.4K | $45.6K | $8.38 | 4.10x |
| G0444 | Annual depression screening, 15 minutes | 2.5K | $41.8K | $16.51 | 1.51x |
| G0008 | Administration of influenza virus vaccine | 2.0K | $41.4K | $21.09 | 1.45x |
| G0446 | Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes | 1.5K | $36.9K | $24.61 | 1.22x |
| 82306 | Vitamin D-3 level | 1.1K | $36.8K | $33.63 | 3.24x |
This provider submits charges 2.23 times higher than what Medicare actually pays.
A markup ratio of 2.23x means for every $100 Medicare pays, this provider initially charges $223. 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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