This provider's $7.0M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 545% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 461% 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 | $116.12 | $68.37 | 1.70x | $47.75 | $481.9K | 7.0K | 24 |
| 2015 | $117.26 | $65.75 | 1.78x | $51.51 | $416.6K | 6.3K | 23 |
| 2016 | $117.98 | $64.78 | 1.82x | $53.20 | $401.2K | 6.2K | 23 |
| 2017 | $211.52 | $63.16 | 3.35x | $148.36 | $376.8K | 6.0K | 23 |
| 2018 | $245.20 | $73.43 | 3.34x | $171.77 | $319.3K | 4.3K | 18 |
| 2019 | $264.14 | $77.86 | 3.39x | $186.28 | $448.7K | 5.8K | 22 |
| 2020 | $294.26 | $82.09 | 3.58x | $212.17 | $440.6K | 5.4K | 22 |
| 2021 | $312.49 | $83.81 | 3.73x | $228.68 | $435.6K | 5.2K | 23 |
| 2022 | $321.26 | $89.16 | 3.60x | $232.10 | $554.2K | 6.2K | 23 |
| 2023 | $923.73 | $365.67 | 2.53x | $558.06 | $3.1M | 8.5K | 25 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4236 | Carepatch, per square centimeter | 1.8K | $1.8M | $965.26 | 2.27x |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 8.0K | $1.3M | $168.89 | 3.06x |
| Q4253 | Zenith amniotic membrane, per square centimeter | 1.1K | $879.5K | $766.15 | 2.54x |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 10.5K | $751.9K | $71.94 | 3.65x |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 12.3K | $674.8K | $54.77 | 2.48x |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 4.2K | $304.1K | $72.59 | 2.49x |
| 11046 | Removal of muscle and/or tissue, each additional 20.0 sq cm or less | 5.4K | $291.9K | $54.25 | 2.90x |
| 17250 | Application of chemical to stop tissue regrowth in wound | 4.7K | $221.9K | $47.66 | 4.11x |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 1.3K | $144.2K | $107.79 | 2.54x |
| 99307 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes | 4.1K | $139.8K | $34.34 | 2.02x |
| 11045 | Removal of skin and tissue, each additional 20.0 sq cm or less | 3.9K | $112.8K | $28.60 | 2.89x |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 843 | $111.3K | $132.07 | 2.59x |
| 99304 | Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 1.3K | $89.3K | $70.71 | 2.30x |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | 805 | $82.9K | $103.01 | 2.57x |
| 11044 | Removal of bone, 20.0 sq cm or less | 150 | $37.6K | $250.63 | 3.02x |
| 15271 | Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less | 148 | $16.1K | $108.57 | 3.64x |
| 97597 | Removal of tissue from wound, 20.0 sq cm or less | 125 | $10.0K | $80.21 | 3.04x |
| 11047 | Removal of bone, each additional 20.0 sq cm or less | 75 | $7.3K | $97.67 | 3.20x |
| 15275 | Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less | 68 | $7.3K | $107.03 | 3.77x |
| 97598 | Removal of tissue from wound, each additional 20.0 sq cm | 116 | $4.2K | $36.16 | 3.01x |
This provider submits charges 2.75 times higher than what Medicare actually pays.
A markup ratio of 2.75x means for every $100 Medicare pays, this provider initially charges $275. 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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