⚠️ This provider averages 4.0K services per working day — physically unusual for an individual practitioner
Based on 6.1M total services over 6 years (250 working days/year). Learn about impossible service volumes →
Averaging 4.0K services per working day raises questions about billing patterns.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 68% 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 |
|---|---|---|---|---|---|---|---|
| 2018 | $77.72 | $21.59 | 3.60x | $56.13 | $20.9M | 970.4K | 674.9K |
| 2019 | $41.57 | $21.59 | 1.93x | $19.98 | $15.5M | 720.1K | 500.9K |
| 2020 | $54.44 | $21.59 | 2.52x | $32.85 | $26.1M | 1.2M | 841.8K |
| 2021 | $37.15 | $21.59 | 1.72x | $15.56 | $17.1M | 791.1K | 550.2K |
| 2022 | $69.35 | $21.59 | 3.21x | $47.76 | $23.5M | 1.1M | 756.3K |
| 2023 | $40.61 | $21.59 | 1.88x | $19.02 | $27.8M | 1.3M | 896.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office/outpatient visit, low complexity | 1.5M | $27.6M | $19.00 | 1.79x |
| 99214 | Office/outpatient visit, moderate complexity | 566.2K | $18.1M | $31.89 | 2.68x |
| 99203 | Office/outpatient visit, new patient | 724.1K | $16.2M | $22.35 | 2.52x |
| 99215 | Office/outpatient visit, high complexity | 722.4K | $11.5M | $15.90 | 2.85x |
| 71046 | Chest X-ray, 2 views | 364.8K | $6.6M | $18.22 | 2.86x |
| 85025 | Complete blood cell count | 329.0K | $6.0M | $18.30 | 4.36x |
| 36415 | Insertion of needle into vein for blood collection | 229.9K | $5.4M | $23.32 | 3.06x |
| 93000 | Electrocardiogram with interpretation | 171.7K | $4.7M | $27.55 | 3.08x |
| 80053 | Comprehensive metabolic panel | 143.6K | $4.5M | $31.35 | 3.73x |
| 96372 | Therapeutic injection | 197.9K | $4.2M | $21.36 | 2.95x |
This provider submits charges 2 times higher than what Medicare actually pays.
A markup ratio of 2x means for every $100 Medicare pays, this provider initially charges $200. 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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