This provider's $5.9M in total Medicare payments ranks in the 99th percentile of Emergency Medicine providers nationally.
Medicare payments to this provider grew 77% from 2014 to 2023.
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 | $143.96 | $89.33 | 1.61x | $54.63 | $410.1K | 5.2K | 1.7K |
| 2015 | $132.72 | $74.54 | 1.78x | $58.18 | $486.1K | 6.3K | 1.7K |
| 2016 | $123.04 | $62.98 | 1.95x | $60.06 | $668.4K | 8.9K | 2.7K |
| 2017 | $127.87 | $61.74 | 2.07x | $66.13 | $603.9K | 7.8K | 2.3K |
| 2018 | $120.40 | $68.37 | 1.76x | $52.03 | $564.0K | 7.3K | 2.1K |
| 2019 | $148.36 | $84.60 | 1.75x | $63.76 | $554.5K | 7.0K | 2.0K |
| 2020 | $219.98 | $93.39 | 2.36x | $126.59 | $638.3K | 7.9K | 2.0K |
| 2021 | $288.75 | $110.33 | 2.62x | $178.42 | $613.2K | 6.9K | 2.3K |
| 2022 | $318.28 | $110.84 | 2.87x | $207.44 | $609.1K | 6.9K | 2.1K |
| 2023 | $272.26 | $96.60 | 2.82x | $175.66 | $724.4K | 8.0K | 2.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 23.7K | $1.5M | $61.68 | 3.01x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 12.9K | $1.1M | $88.81 | 3.06x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 9.7K | $745.9K | $76.62 | 2.35x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 4.0K | $661.2K | $166.35 | 2.14x |
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 1.1K | $313.6K | $283.81 | 1.92x |
| 90935 | Hemodialysis procedure with one physician evaluation | 3.2K | $197.9K | $61.43 | 2.68x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 1.3K | $181.0K | $139.47 | 1.65x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 3.2K | $180.1K | $56.97 | 2.02x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 853 | $158.9K | $186.24 | 2.27x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.6K | $157.4K | $98.07 | 2.01x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 989 | $112.0K | $113.26 | 2.59x |
| 99443 | Physician telephone patient service, 21-30 minutes of medical discussion | 927 | $80.1K | $86.37 | 2.32x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 1.2K | $79.3K | $66.08 | 1.74x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 1.1K | $69.3K | $65.80 | 2.26x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 1.4K | $48.2K | $35.47 | 2.59x |
| 99239 | Hospital discharge day management, more than 30 minutes | 501 | $45.4K | $90.63 | 2.33x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 220 | $37.8K | $171.87 | 1.77x |
| 99238 | Hospital discharge day management, 30 minutes or less | 507 | $31.1K | $61.26 | 1.70x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 160 | $15.5K | $96.86 | 2.58x |
| 99215 | Established patient outpatient visit, total time 40-54 minutes | 90 | $14.1K | $156.97 | 1.81x |
This provider submits charges 2.57 times higher than what Medicare actually pays.
A markup ratio of 2.57x means for every $100 Medicare pays, this provider initially charges $257. 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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