This provider's $3.8M in total Medicare payments ranks in the 99th percentile of Hospitalist providers nationally.
Medicare payments to this provider grew 751% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 317% in 2020
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 | $550.40 | $109.02 | 5.05x | $441.38 | $103.8K | 1.2K | 648 |
| 2015 | $535.73 | $110.22 | 4.86x | $425.51 | $100.8K | 1.0K | 622 |
| 2016 | $441.32 | $103.14 | 4.28x | $338.18 | $121.9K | 1.3K | 832 |
| 2017 | $557.69 | $96.61 | 5.77x | $461.08 | $124.3K | 1.3K | 804 |
| 2018 | $483.88 | $99.75 | 4.85x | $384.13 | $131.8K | 1.4K | 909 |
| 2019 | $630.40 | $118.57 | 5.32x | $511.83 | $112.0K | 1.2K | 801 |
| 2020 | $284.77 | $95.86 | 2.97x | $188.91 | $467.4K | 5.8K | 1.6K |
| 2021 | $274.70 | $91.68 | 3.00x | $183.02 | $809.0K | 10.5K | 2.3K |
| 2022 | $277.17 | $90.97 | 3.05x | $186.20 | $910.5K | 12.5K | 3.1K |
| 2023 | $274.56 | $98.18 | 2.80x | $176.38 | $883.1K | 11.0K | 3.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 19.3K | $1.2M | $64.12 | 2.00x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 11.7K | $1.0M | $85.98 | 2.05x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 4.2K | $399.7K | $95.03 | 4.80x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 1.7K | $267.8K | $154.82 | 1.63x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 4.0K | $263.7K | $66.59 | 4.69x |
| 99239 | Hospital discharge day management, more than 30 minutes | 1.5K | $145.8K | $97.75 | 4.95x |
| 99316 | Nursing facility discharge management, more than 30 minutes | 1.3K | $135.2K | $101.57 | 1.98x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 656 | $118.5K | $180.70 | 4.84x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 1.2K | $60.0K | $51.53 | 2.74x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 697 | $53.3K | $76.46 | 1.96x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 218 | $26.6K | $121.83 | 4.74x |
| G0179 | Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp | 346 | $13.7K | $39.47 | 1.66x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 101 | $12.5K | $123.68 | 1.62x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 195 | $7.4K | $38.14 | 2.63x |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | 55 | $6.7K | $121.74 | 2.22x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 31 | $6.3K | $203.36 | 6.57x |
| 99238 | Hospital discharge day management, 30 minutes or less | 31 | $2.1K | $66.23 | 4.33x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 19 | $1.8K | $93.64 | 4.90x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 38 | $1.3K | $35.47 | 6.07x |
This provider submits charges 2.72 times higher than what Medicare actually pays.
A markup ratio of 2.72x means for every $100 Medicare pays, this provider initially charges $272. 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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