This provider's $7.5M in total Medicare payments ranks in the 99th percentile of Internal 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 | $192.60 | $90.49 | 2.13x | $102.11 | $659.4K | 9.4K | 3.1K |
| 2015 | $209.04 | $90.89 | 2.30x | $118.15 | $852.8K | 11.8K | 3.8K |
| 2016 | $235.85 | $93.08 | 2.53x | $142.77 | $924.2K | 12.9K | 4.3K |
| 2017 | $229.11 | $83.77 | 2.73x | $145.34 | $766.0K | 10.6K | 4.0K |
| 2018 | $216.38 | $75.23 | 2.88x | $141.15 | $661.2K | 9.6K | 3.9K |
| 2019 | $230.01 | $84.26 | 2.73x | $145.75 | $622.5K | 8.5K | 3.5K |
| 2020 | $237.89 | $89.68 | 2.65x | $148.21 | $711.8K | 9.2K | 3.5K |
| 2021 | $226.66 | $91.62 | 2.47x | $135.04 | $685.2K | 8.4K | 3.8K |
| 2022 | $242.01 | $93.34 | 2.59x | $148.67 | $764.9K | 8.9K | 4.2K |
| 2023 | $233.55 | $96.24 | 2.43x | $137.31 | $883.5K | 9.8K | 4.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99335 | Established patient assisted living visit, typically 25 minutes | 19.2K | $1.5M | $77.44 | 2.35x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 22.1K | $1.3M | $57.45 | 3.17x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 20.7K | $1.3M | $60.84 | 2.65x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 3.2K | $358.5K | $111.64 | 2.41x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.8K | $300.7K | $164.92 | 1.88x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 3.1K | $282.2K | $91.10 | 2.47x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 3.4K | $265.4K | $79.19 | 2.98x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 2.0K | $223.8K | $113.79 | 2.48x |
| 99349 | Established patient home visit, typically 40 minutes | 2.0K | $209.4K | $105.11 | 1.87x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 1.9K | $208.4K | $109.77 | 2.57x |
| 99238 | Hospital discharge day management, 30 minutes or less | 3.0K | $186.1K | $61.82 | 2.58x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 1.2K | $177.7K | $143.46 | 2.55x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.9K | $174.1K | $92.01 | 2.19x |
| 99495 | Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge | 1.0K | $165.8K | $159.14 | 2.03x |
| 99239 | Hospital discharge day management, more than 30 minutes | 1.6K | $148.7K | $90.53 | 2.32x |
| 99304 | Initial nursing facility visit, typically 25 minutes per day | 1.7K | $128.9K | $75.45 | 2.96x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 1.4K | $120.9K | $83.69 | 2.37x |
| 99327 | New patient assisted living visit, typically 60 minutes | 498 | $76.8K | $154.31 | 2.32x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.2K | $71.3K | $61.38 | 2.32x |
| 99315 | Nursing facility discharge day management, 30 minutes or less | 1.1K | $67.7K | $61.79 | 3.44x |
This provider submits charges 2.59 times higher than what Medicare actually pays.
A markup ratio of 2.59x means for every $100 Medicare pays, this provider initially charges $259. This is higher 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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