This provider's $4.8M in total Medicare payments ranks in the 99th percentile of Geriatric Medicine providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $126.14 | $61.75 | 2.04x | $64.39 | $424.7K | 6.9K | 3.6K |
| 2015 | $109.17 | $54.59 | 2.00x | $54.58 | $364.9K | 6.2K | 3.5K |
| 2016 | $121.48 | $58.48 | 2.08x | $63.00 | $422.2K | 7.5K | 4.3K |
| 2017 | $117.60 | $59.24 | 1.99x | $58.36 | $438.2K | 8.0K | 4.9K |
| 2018 | $115.45 | $58.32 | 1.98x | $57.13 | $447.9K | 8.8K | 5.8K |
| 2019 | $111.94 | $60.14 | 1.86x | $51.80 | $503.0K | 9.0K | 5.8K |
| 2020 | $97.12 | $61.53 | 1.58x | $35.59 | $500.7K | 9.9K | 5.7K |
| 2021 | $104.21 | $70.37 | 1.48x | $33.84 | $530.5K | 9.6K | 5.2K |
| 2022 | $110.27 | $72.59 | 1.52x | $37.68 | $518.6K | 9.6K | 5.3K |
| 2023 | $107.39 | $68.13 | 1.58x | $39.26 | $600.8K | 10.4K | 5.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 14.8K | $1.2M | $80.72 | 2.19x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 7.2K | $600.9K | $83.74 | 1.83x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 3.8K | $459.3K | $120.72 | 1.43x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 3.7K | $273.0K | $74.38 | 1.50x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.4K | $213.7K | $155.41 | 1.95x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 4.2K | $190.3K | $45.24 | 1.73x |
| 99457 | Remote physiologic monitoring treatment management services, health care professional time in a calendar month requiring interactive communication with the patient/caregiver; first 20 minutes | 4.1K | $161.5K | $39.85 | 1.63x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.3K | $150.4K | $115.67 | 1.95x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 592 | $112.1K | $189.36 | 1.70x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 636 | $107.0K | $168.17 | 1.48x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.7K | $91.5K | $53.40 | 2.16x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 2.2K | $90.6K | $40.31 | 1.56x |
| G0446 | Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes | 3.3K | $86.1K | $26.13 | 1.42x |
| 99239 | Hospital discharge day management, more than 30 minutes | 929 | $79.1K | $85.18 | 2.06x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 626 | $72.6K | $116.02 | 2.27x |
| 99491 | Chronic care management services by qualified health care professional, 30 minutes or more per calendar month | 991 | $66.9K | $67.47 | 1.71x |
| G0444 | Annual depression screening, 15 minutes | 3.7K | $66.6K | $18.21 | 1.47x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 937 | $52.9K | $56.47 | 2.02x |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 2.0K | $51.9K | $26.22 | 1.36x |
| 99441 | Physician telephone patient service, 5-10 minutes of medical discussion | 983 | $42.1K | $42.87 | 1.36x |
This provider submits charges 1.86 times higher than what Medicare actually pays.
A markup ratio of 1.86x means for every $100 Medicare pays, this provider initially charges $186. 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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