This provider's $3.4M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 221% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 105% in 2022
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 | $113.80 | $46.64 | 2.44x | $67.16 | $198.9K | 4.7K | 2.3K |
| 2015 | $83.46 | $37.80 | 2.21x | $45.66 | $184.3K | 5.3K | 2.7K |
| 2016 | $77.88 | $37.47 | 2.08x | $40.41 | $243.9K | 7.7K | 3.1K |
| 2017 | $75.36 | $31.27 | 2.41x | $44.09 | $241.6K | 8.1K | 3.1K |
| 2018 | $73.56 | $32.81 | 2.24x | $40.75 | $244.7K | 7.8K | 2.8K |
| 2019 | $95.49 | $46.33 | 2.06x | $49.16 | $356.9K | 10.1K | 3.3K |
| 2020 | $90.33 | $43.31 | 2.09x | $47.02 | $337.2K | 10.6K | 3.0K |
| 2021 | $84.89 | $40.49 | 2.10x | $44.40 | $320.4K | 10.1K | 3.4K |
| 2022 | $79.10 | $38.35 | 2.06x | $40.75 | $657.7K | 17.2K | 4.7K |
| 2023 | $77.95 | $38.32 | 2.03x | $39.63 | $638.5K | 16.5K | 4.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99490 | Chronic care management services at least 20 minutes per calendar month | 43.6K | $1.4M | $32.24 | 1.97x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 11.0K | $533.4K | $48.69 | 2.00x |
| 99439 | Chronic care management services, each additional 20 minutes of clinical staff time per calendar month | 10.1K | $332.3K | $33.06 | 1.81x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 6.6K | $316.0K | $47.79 | 1.67x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 1.4K | $155.6K | $114.69 | 2.38x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 988 | $94.4K | $95.59 | 1.57x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 595 | $54.2K | $91.11 | 2.36x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 1.3K | $49.4K | $38.95 | 2.18x |
| 80307 | Testing for presence of drug, by chemistry analyzers | 802 | $48.8K | $60.91 | 1.64x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 542 | $40.5K | $74.80 | 1.98x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 555 | $35.0K | $63.07 | 2.49x |
| 99457 | Management using the results of remote vital sign monitoring per calendar month, first 20 minutes | 877 | $32.3K | $36.79 | 2.17x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 2.1K | $26.6K | $12.70 | 2.91x |
| 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 | 599 | $23.0K | $38.37 | 2.22x |
| G0008 | Administration of influenza virus vaccine | 1.0K | $21.7K | $21.55 | 1.16x |
| G0444 | Annual depression screening, 15 minutes | 908 | $15.7K | $17.29 | 1.45x |
| G0506 | Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) | 377 | $14.6K | $38.65 | 1.81x |
| 95250 | Ambulatory continuous glucose (sugar) monitoring for a minimum of 72 hours | 126 | $13.1K | $103.81 | 1.88x |
| 36415 | Insertion of needle into vein for collection of blood sample | 3.4K | $12.6K | $3.69 | 5.70x |
| 85610 | Blood test, clotting time | 2.5K | $12.6K | $5.05 | 5.94x |
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.
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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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