This provider's $5.6M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 205% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 71% in 2016
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 |
|---|---|---|---|---|---|---|---|
| 2014 | $104.53 | $69.93 | 1.49x | $34.60 | $295.6K | 3.6K | 1.1K |
| 2015 | $113.81 | $75.17 | 1.51x | $38.64 | $257.8K | 3.4K | 925 |
| 2016 | $108.33 | $71.44 | 1.52x | $36.89 | $441.3K | 5.4K | 1.3K |
| 2017 | $115.49 | $78.83 | 1.47x | $36.66 | $349.9K | 4.1K | 1.1K |
| 2018 | $118.97 | $78.43 | 1.52x | $40.54 | $404.7K | 5.0K | 1.1K |
| 2019 | $118.39 | $76.94 | 1.54x | $41.45 | $555.1K | 6.5K | 1.1K |
| 2020 | $119.67 | $74.14 | 1.61x | $45.53 | $704.4K | 9.0K | 961 |
| 2021 | $129.57 | $83.35 | 1.55x | $46.22 | $868.7K | 10.7K | 1.0K |
| 2022 | $143.74 | $83.68 | 1.72x | $60.06 | $780.2K | 9.9K | 902 |
| 2023 | $177.41 | $96.41 | 1.84x | $81.00 | $901.0K | 10.4K | 807 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 36.7K | $2.7M | $74.69 | 1.60x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 4.2K | $615.7K | $147.16 | 1.44x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 5.5K | $565.7K | $103.68 | 1.45x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.8K | $422.3K | $88.90 | 1.62x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 2.9K | $323.0K | $111.51 | 1.50x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 1.5K | $280.7K | $193.44 | 1.36x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 1.8K | $187.8K | $103.36 | 1.46x |
| 99350 | Established patient home visit, typically 60 minutes | 823 | $110.6K | $134.37 | 1.45x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 384 | $51.8K | $134.87 | 1.49x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 2.9K | $49.2K | $17.13 | 2.03x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 754 | $41.7K | $55.31 | 1.57x |
| G0180 | Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple | 973 | $39.3K | $40.37 | 1.64x |
| 99328 | New patient assisted living visit, typically 75 minutes | 146 | $23.8K | $162.70 | 1.45x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 222 | $23.1K | $103.84 | 2.74x |
| G0179 | Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial im | 380 | $11.9K | $31.41 | 1.69x |
| 90662 | Vaccine for influenza for injection into muscle | 179 | $10.0K | $55.94 | 1.17x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 84 | $9.6K | $114.46 | 1.57x |
| 99349 | Established patient home visit, typically 40 minutes | 72 | $7.0K | $96.71 | 1.67x |
| G0008 | Administration of influenza virus vaccine | 319 | $6.9K | $21.78 | 1.58x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 148 | $4.8K | $32.11 | 1.66x |
This provider submits charges 1.55 times higher than what Medicare actually pays.
A markup ratio of 1.55x means for every $100 Medicare pays, this provider initially charges $155. This is lower 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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