This provider's $4.4M in total Medicare payments ranks in the 99th percentile of Family Practice 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 | $100.00 | $32.55 | 3.07x | $67.45 | $372.0K | 13.0K | 5.4K |
| 2015 | $90.61 | $30.54 | 2.97x | $60.07 | $395.7K | 14.9K | 6.8K |
| 2016 | $84.51 | $27.59 | 3.06x | $56.92 | $389.9K | 15.5K | 6.8K |
| 2017 | $102.00 | $35.79 | 2.85x | $66.21 | $377.2K | 15.2K | 6.9K |
| 2018 | $100.59 | $25.84 | 3.89x | $74.75 | $444.6K | 16.7K | 7.6K |
| 2019 | $105.58 | $26.51 | 3.98x | $79.07 | $490.5K | 16.6K | 7.4K |
| 2020 | $103.13 | $27.01 | 3.82x | $76.12 | $486.5K | 11.8K | 6.3K |
| 2021 | $113.45 | $37.88 | 2.99x | $75.57 | $489.0K | 7.6K | 3.1K |
| 2022 | $145.69 | $50.75 | 2.87x | $94.94 | $531.6K | 7.7K | 3.1K |
| 2023 | $132.12 | $41.41 | 3.19x | $90.71 | $397.8K | 6.4K | 2.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 21.3K | $1.3M | $60.23 | 2.43x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 13.4K | $1.2M | $91.62 | 2.88x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 8.8K | $589.9K | $66.76 | 1.35x |
| 82306 | Vitamin D-3 level | 3.4K | $123.9K | $36.66 | 2.11x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.0K | $105.1K | $104.81 | 1.96x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 3.9K | $82.4K | $21.01 | 3.49x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 1.9K | $77.5K | $40.23 | 3.41x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 2.3K | $74.6K | $32.78 | 3.23x |
| 84480 | Thyroid hormone, T3 measurement | 3.9K | $69.6K | $17.72 | 2.94x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 4.3K | $49.5K | $11.40 | 5.10x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 4.9K | $48.0K | $9.75 | 5.90x |
| 99441 | Physician telephone patient service, 5-10 minutes of medical discussion | 992 | $46.7K | $47.13 | 2.09x |
| 80048 | Blood test, basic group of blood chemicals | 4.6K | $46.7K | $10.22 | 6.79x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 346 | $40.2K | $116.27 | 2.72x |
| 82948 | Blood glucose (sugar) measurement using reagent strip | 9.1K | $39.3K | $4.32 | 9.26x |
| 84436 | Thyroxine (thyroid chemical) measurement | 3.9K | $33.7K | $8.58 | 4.60x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 730 | $32.4K | $44.39 | 4.69x |
| 80076 | Liver function blood test panel | 3.9K | $30.3K | $7.87 | 6.53x |
| J7321 | Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose | 439 | $29.6K | $67.31 | 3.00x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 1.0K | $26.8K | $26.17 | 2.87x |
This provider submits charges 2.86 times higher than what Medicare actually pays.
A markup ratio of 2.86x means for every $100 Medicare pays, this provider initially charges $286. 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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