This provider averages 85 services per working day
Based on 213.2K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $11.3M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Averaging 85 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 | $83.30 | $49.27 | 1.69x | $34.03 | $1.2M | 21.7K | 12.8K |
| 2015 | $81.08 | $49.38 | 1.64x | $31.70 | $1.3M | 24.4K | 14.0K |
| 2016 | $82.54 | $50.13 | 1.65x | $32.41 | $1.1M | 22.0K | 13.0K |
| 2017 | $77.76 | $45.29 | 1.72x | $32.47 | $1.1M | 21.8K | 13.5K |
| 2018 | $78.74 | $46.91 | 1.68x | $31.83 | $1.1M | 24.0K | 15.6K |
| 2019 | $82.82 | $48.59 | 1.70x | $34.23 | $1.1M | 23.2K | 14.9K |
| 2020 | $81.43 | $47.91 | 1.70x | $33.52 | $1.0M | 21.5K | 14.0K |
| 2021 | $85.70 | $51.86 | 1.65x | $33.84 | $1.1M | 18.8K | 12.1K |
| 2022 | $94.28 | $55.35 | 1.70x | $38.93 | $1.1M | 18.4K | 11.7K |
| 2023 | $97.27 | $54.82 | 1.77x | $42.45 | $1.1M | 17.3K | 11.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 69.2K | $5.3M | $77.23 | 1.72x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 13.0K | $1.5M | $118.37 | 1.28x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 8.6K | $927.7K | $107.94 | 1.66x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 13.7K | $705.9K | $51.42 | 1.90x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 7.9K | $457.6K | $57.89 | 2.11x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 2.5K | $409.5K | $165.26 | 1.19x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.6K | $259.7K | $100.43 | 2.05x |
| G0444 | Annual depression screening, 15 minutes | 12.4K | $218.6K | $17.69 | 1.41x |
| G0008 | Administration of influenza virus vaccine | 8.7K | $196.3K | $22.45 | 1.54x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 10.2K | $147.3K | $14.46 | 2.07x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 820 | $120.3K | $146.71 | 1.71x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 594 | $111.0K | $186.92 | 1.39x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 6.6K | $90.5K | $13.74 | 2.55x |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 514 | $82.6K | $160.78 | 1.27x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.5K | $82.4K | $56.81 | 2.41x |
| G0180 | Physician 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 imple | 2.0K | $80.4K | $39.86 | 1.50x |
| 90688 | Vaccine for influenza for administration into muscle, 0.5 ml dosage | 2.8K | $53.1K | $18.75 | 1.87x |
| 85610 | Blood test, clotting time | 10.6K | $51.7K | $4.87 | 2.05x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 1.4K | $50.3K | $36.28 | 1.76x |
| 99495 | Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge | 325 | $43.2K | $132.79 | 1.46x |
This provider submits charges 1.69 times higher than what Medicare actually pays.
A markup ratio of 1.69x means for every $100 Medicare pays, this provider initially charges $169. This is lower 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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