This provider averages 72 services per working day
Based on 179.8K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $8.2M in total Medicare payments ranks in the 99th percentile of Pulmonary Disease providers nationally.
Averaging 72 services per working day raises questions about billing patterns.
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 | $158.56 | $54.37 | 2.92x | $104.19 | $955.2K | 22.4K | 13.1K |
| 2015 | $185.16 | $52.93 | 3.50x | $132.23 | $944.8K | 21.0K | 13.0K |
| 2016 | $172.20 | $52.13 | 3.30x | $120.07 | $970.0K | 21.9K | 13.8K |
| 2017 | $173.63 | $52.40 | 3.31x | $121.23 | $997.1K | 22.2K | 13.9K |
| 2018 | $199.64 | $55.05 | 3.63x | $144.59 | $882.6K | 20.0K | 13.1K |
| 2019 | $184.81 | $53.81 | 3.43x | $131.00 | $821.5K | 18.7K | 12.7K |
| 2020 | $169.75 | $52.15 | 3.26x | $117.60 | $612.3K | 13.4K | 9.2K |
| 2021 | $177.62 | $52.53 | 3.38x | $125.09 | $709.8K | 14.0K | 10.0K |
| 2022 | $182.13 | $51.86 | 3.51x | $130.27 | $635.3K | 13.1K | 9.4K |
| 2023 | $210.49 | $55.46 | 3.80x | $155.03 | $622.7K | 13.1K | 9.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 32.1K | $2.3M | $73.27 | 1.84x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 11.4K | $598.9K | $52.42 | 1.80x |
| 94060 | Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration | 14.0K | $472.2K | $33.83 | 3.69x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 4.4K | $435.8K | $99.81 | 4.88x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 2.6K | $372.9K | $143.37 | 1.77x |
| 94729 | Measurement of lung diffusing capacity | 10.5K | $364.7K | $34.74 | 2.20x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 4.4K | $346.1K | $78.51 | 1.79x |
| 94375 | Diagnostic testing in a pulmonary function lab | 23.4K | $314.8K | $13.45 | 6.37x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 2.9K | $310.7K | $106.12 | 4.61x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 2.8K | $277.4K | $97.65 | 1.78x |
| 94727 | Determination of lung volumes using gas dilution or washout | 9.5K | $275.5K | $28.94 | 2.10x |
| 31645 | Aspiration of lung secretions from lung airways using an endoscope | 1.9K | $216.0K | $111.65 | 4.43x |
| 94010 | Measurement and graphic recording of total and timed exhaled air capacity | 9.4K | $201.3K | $21.50 | 3.19x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.7K | $191.2K | $112.30 | 1.55x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 3.1K | $148.7K | $48.13 | 1.76x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 615 | $104.7K | $170.28 | 1.98x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.0K | $104.3K | $51.86 | 1.90x |
| 99238 | Hospital discharge day management, 30 minutes or less | 1.7K | $88.9K | $52.43 | 1.74x |
| 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 13.8K | $80.8K | $5.84 | 9.86x |
| 95811 | Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube | 854 | $76.9K | $90.00 | 6.70x |
This provider submits charges 2.8 times higher than what Medicare actually pays.
A markup ratio of 2.8x means for every $100 Medicare pays, this provider initially charges $280. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
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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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