This provider's $4.7M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 82% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 52% in 2023
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 | $163.91 | $89.83 | 1.82x | $74.08 | $375.8K | 4.7K | 2.6K |
| 2015 | $103.48 | $70.53 | 1.47x | $32.95 | $397.3K | 5.6K | 3.8K |
| 2016 | $101.41 | $71.25 | 1.42x | $30.16 | $400.8K | 6.3K | 4.2K |
| 2017 | $104.11 | $70.94 | 1.47x | $33.17 | $564.2K | 8.4K | 5.1K |
| 2018 | $108.39 | $74.17 | 1.46x | $34.22 | $429.3K | 7.4K | 5.0K |
| 2019 | $105.13 | $76.82 | 1.37x | $28.31 | $320.5K | 5.1K | 3.6K |
| 2020 | $118.63 | $82.95 | 1.43x | $35.68 | $432.4K | 6.5K | 4.7K |
| 2021 | $116.83 | $82.39 | 1.42x | $34.44 | $614.7K | 7.7K | 5.4K |
| 2022 | $133.20 | $103.43 | 1.29x | $29.77 | $451.9K | 5.2K | 4.1K |
| 2023 | $121.18 | $85.93 | 1.41x | $35.25 | $685.4K | 7.7K | 5.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 23.4K | $1.6M | $67.69 | 1.63x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 13.5K | $1.2M | $91.08 | 1.49x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 2.6K | $384.0K | $150.04 | 1.17x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.6K | $212.8K | $130.33 | 1.54x |
| 90662 | Vaccine for influenza for injection into muscle | 2.6K | $156.7K | $59.32 | 1.14x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 656 | $130.2K | $198.51 | 1.13x |
| 90670 | Pneumococcal vaccine for injection into muscle | 596 | $116.1K | $194.73 | 1.10x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.6K | $106.3K | $64.73 | 1.56x |
| G0008 | Administration of influenza virus vaccine | 3.6K | $97.6K | $27.04 | 1.31x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.1K | $90.4K | $85.43 | 1.75x |
| G0444 | Annual depression screening, 15 minutes | 4.8K | $86.5K | $18.03 | 1.07x |
| 99497 | Advance care planning, first 30 minutes | 883 | $82.1K | $93.01 | 1.08x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 263 | $53.0K | $201.61 | 1.36x |
| 90732 | Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older | 384 | $38.6K | $100.50 | 1.11x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 310 | $38.1K | $122.90 | 1.45x |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 165 | $32.6K | $197.77 | 1.36x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 654 | $27.9K | $42.70 | 1.65x |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 91 | $25.5K | $280.23 | 1.17x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 156 | $23.4K | $149.89 | 1.33x |
| 90686 | Vaccine for influenza administered into muscle to individuals 3 years of age and older | 1.1K | $20.4K | $18.27 | 1.38x |
This provider submits charges 1.49 times higher than what Medicare actually pays.
A markup ratio of 1.49x means for every $100 Medicare pays, this provider initially charges $149. This is lower 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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