This provider's $4.4M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Their average markup ratio of 5.1x is significantly above the specialty median of 2.9x.
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 | $733.00 | $136.16 | 5.38x | $596.84 | $370.0K | 3.6K | 1.1K |
| 2015 | $650.52 | $130.03 | 5.00x | $520.49 | $370.4K | 3.5K | 1.0K |
| 2016 | $745.50 | $138.06 | 5.40x | $607.44 | $398.7K | 3.4K | 958 |
| 2017 | $615.05 | $127.88 | 4.81x | $487.17 | $409.0K | 3.2K | 959 |
| 2018 | $665.46 | $130.92 | 5.08x | $534.54 | $449.6K | 5.0K | 1.1K |
| 2019 | $664.44 | $130.48 | 5.09x | $533.96 | $462.8K | 3.3K | 940 |
| 2020 | $715.13 | $132.93 | 5.38x | $582.20 | $447.4K | 3.1K | 908 |
| 2021 | $542.67 | $156.19 | 3.47x | $386.48 | $554.2K | 3.2K | 953 |
| 2022 | $518.33 | $158.83 | 3.26x | $359.50 | $513.9K | 3.2K | 958 |
| 2023 | $519.60 | $150.76 | 3.45x | $368.84 | $425.0K | 3.2K | 831 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 6.6K | $2.1M | $321.69 | 5.54x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 1.8K | $471.4K | $263.36 | 5.42x |
| 90966 | Home dialysis services per month, patient 20 years of age or older | 1.6K | $423.9K | $259.11 | 4.64x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.4K | $240.8K | $99.23 | 2.76x |
| 90935 | Hemodialysis procedure with one physician evaluation | 2.3K | $178.4K | $77.61 | 7.40x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.6K | $174.2K | $110.59 | 3.62x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 799 | $167.5K | $209.63 | 3.80x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.7K | $126.8K | $76.76 | 3.73x |
| 90970 | Dialysis services, per day (less than full month service), patient 20 years of age or older | 12.0K | $101.5K | $8.47 | 3.99x |
| 90945 | Dialysis procedure including one evaluation | 738 | $66.2K | $89.64 | 6.53x |
| 90937 | Hemodialysis procedure with repeated evaluations | 571 | $63.3K | $110.81 | 7.48x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 1.1K | $47.3K | $42.33 | 4.41x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 224 | $44.2K | $197.32 | 5.24x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 160 | $32.2K | $201.24 | 2.55x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 180 | $25.9K | $143.89 | 2.89x |
| 99239 | Hospital discharge day management, more than 30 minutes | 230 | $25.7K | $111.72 | 4.17x |
| 36589 | Removal of central venous catheter for infusion | 137 | $22.1K | $161.61 | 4.39x |
| 90947 | Dialysis procedure requiring repeat evaluation | 111 | $14.8K | $133.55 | 6.56x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 91 | $13.0K | $143.02 | 2.76x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 159 | $10.6K | $66.68 | 2.69x |
This provider submits charges 5.1 times higher than what Medicare actually pays.
A markup ratio of 5.1x means for every $100 Medicare pays, this provider initially charges $510. 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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