This provider's $4.3M in total Medicare payments ranks in the 99th percentile of Physician Assistant providers nationally.
Medicare payments to this provider grew 146% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 69% in 2016
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 | $142.71 | $74.17 | 1.92x | $68.54 | $235.3K | 4.7K | 872 |
| 2015 | $134.00 | $74.99 | 1.79x | $59.01 | $253.1K | 4.9K | 930 |
| 2016 | $124.54 | $62.75 | 1.98x | $61.79 | $428.2K | 8.3K | 2.4K |
| 2017 | $237.45 | $76.80 | 3.09x | $160.65 | $450.2K | 9.2K | 2.3K |
| 2018 | $340.92 | $67.31 | 5.06x | $273.61 | $424.2K | 8.9K | 3.0K |
| 2019 | $344.53 | $72.24 | 4.77x | $272.29 | $329.3K | 6.6K | 1.5K |
| 2020 | $251.23 | $68.00 | 3.69x | $183.23 | $482.4K | 9.7K | 2.4K |
| 2021 | $175.46 | $69.97 | 2.51x | $105.49 | $570.3K | 10.0K | 2.2K |
| 2022 | $188.78 | $76.61 | 2.46x | $112.17 | $591.2K | 9.5K | 2.0K |
| 2023 | $221.51 | $92.00 | 2.41x | $129.51 | $579.7K | 9.4K | 2.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 39.0K | $2.4M | $60.85 | 3.20x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 23.5K | $889.4K | $37.85 | 3.63x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 9.9K | $415.8K | $42.01 | 2.45x |
| 99495 | Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge | 949 | $151.2K | $159.37 | 2.43x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.5K | $124.9K | $83.74 | 2.32x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 677 | $122.8K | $181.46 | 3.28x |
| G0506 | Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) | 923 | $45.7K | $49.48 | 2.44x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 332 | $41.3K | $124.40 | 2.78x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 1.0K | $34.1K | $33.87 | 2.48x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 387 | $34.0K | $87.98 | 3.52x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 473 | $25.0K | $52.75 | 2.46x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 138 | $17.6K | $127.57 | 2.46x |
| G0008 | Administration of influenza virus vaccine | 530 | $14.2K | $26.83 | 2.72x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 209 | $14.0K | $67.20 | 2.56x |
| G0446 | Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes | 289 | $8.0K | $27.64 | 2.35x |
| G0444 | Annual depression screening, 15 minutes | 450 | $7.9K | $17.65 | 6.06x |
| 90756 | Vaccine for influenza for injection into muscle | 209 | $5.1K | $24.26 | 2.06x |
| 99284 | Emergency department visit, problem of high severity | 52 | $4.8K | $92.84 | 3.71x |
| Q2039 | Influenza virus vaccine, not otherwise specified | 198 | $4.4K | $22.27 | 2.25x |
| G0442 | Annual alcohol misuse screening, 15 minutes | 225 | $4.1K | $18.01 | 5.66x |
This provider submits charges 3.14 times higher than what Medicare actually pays.
A markup ratio of 3.14x means for every $100 Medicare pays, this provider initially charges $314. 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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