This provider's $3.5M in total Medicare payments ranks in the 99th percentile of Neurology 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 | $222.58 | $71.05 | 3.13x | $151.53 | $373.1K | 6.8K | 2.9K |
| 2015 | $240.15 | $77.16 | 3.11x | $162.99 | $377.7K | 6.7K | 2.7K |
| 2016 | $223.85 | $71.23 | 3.14x | $152.62 | $437.7K | 8.0K | 3.2K |
| 2017 | $213.83 | $67.38 | 3.17x | $146.45 | $352.4K | 7.9K | 2.3K |
| 2018 | $211.38 | $66.02 | 3.20x | $145.36 | $334.2K | 7.7K | 2.1K |
| 2019 | $245.01 | $73.97 | 3.31x | $171.04 | $359.3K | 6.0K | 2.4K |
| 2020 | $293.67 | $83.44 | 3.52x | $210.23 | $324.7K | 5.1K | 2.2K |
| 2021 | $284.11 | $81.77 | 3.47x | $202.34 | $329.9K | 5.4K | 2.2K |
| 2022 | $288.81 | $80.82 | 3.57x | $207.99 | $335.8K | 5.4K | 2.3K |
| 2023 | $296.52 | $84.48 | 3.51x | $212.04 | $290.9K | 5.2K | 2.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 17.6K | $963.2K | $54.78 | 1.83x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.2K | $461.3K | $74.05 | 2.97x |
| 95816 | Measurement and recording of brain wave (EEG) activity, awake and drowsy | 3.5K | $450.1K | $127.65 | 3.39x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 2.8K | $282.6K | $101.36 | 2.96x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 4.2K | $210.9K | $49.93 | 3.80x |
| 95913 | Nerve transmission studies, 13 or more studies | 661 | $114.4K | $173.06 | 3.14x |
| 95911 | Nerve transmission studies, 9-10 studies | 732 | $93.9K | $128.22 | 2.87x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 799 | $88.4K | $110.67 | 3.16x |
| 95886 | Needle measurement and recording of electrical activity of muscles of arm or leg complete study | 1.7K | $83.2K | $47.85 | 3.01x |
| 95720 | Continuous measurement of brain wave activity with video (veeg), 12-26 hours, with health care professional analysis, interpretation and report | 463 | $74.0K | $159.84 | 8.04x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.4K | $73.8K | $50.94 | 2.94x |
| 96366 | Infusion into a vein for therapy, prevention, or diagnosis | 4.1K | $60.5K | $14.87 | 7.40x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 763 | $60.0K | $78.65 | 1.91x |
| 96375 | Injection of different drug or substance into a vein for therapy, diagnosis, or prevention | 3.9K | $54.0K | $13.92 | 4.65x |
| 95819 | Measurement and recording of brain wave (EEG) activity, awake and asleep | 180 | $51.0K | $283.45 | 3.00x |
| J1561 | Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g. liquid), 500 mg | 1.6K | $50.8K | $31.92 | 3.52x |
| 95951 | Monitoring and localization of seizure activity over 24-hour period using 16-channel electroencephalograph (EEG) | 156 | $38.1K | $244.46 | 5.25x |
| 96116 | Neurobehavioral status examination, interpretation, and report by psychologist or physician per hour | 540 | $36.9K | $68.29 | 2.64x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 1.2K | $26.1K | $21.92 | 3.61x |
| J1568 | Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg | 810 | $25.8K | $31.90 | 3.53x |
This provider submits charges 3.03 times higher than what Medicare actually pays.
A markup ratio of 3.03x means for every $100 Medicare pays, this provider initially charges $303. 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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