This provider averages 82 services per working day
Based on 205.2K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $7.3M in total Medicare payments ranks in the 99th percentile of Infectious Disease providers nationally.
Averaging 82 services per working day raises questions about billing patterns.
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 | $171.94 | $53.13 | 3.24x | $118.81 | $1.1M | 30.3K | 4.7K |
| 2015 | $181.66 | $57.52 | 3.16x | $124.14 | $896.8K | 24.3K | 4.1K |
| 2016 | $164.55 | $52.64 | 3.13x | $111.91 | $842.3K | 24.2K | 3.9K |
| 2017 | $146.78 | $43.24 | 3.39x | $103.54 | $711.0K | 21.6K | 3.5K |
| 2018 | $162.49 | $51.27 | 3.17x | $111.22 | $751.6K | 21.9K | 3.3K |
| 2019 | $159.21 | $51.06 | 3.12x | $108.15 | $706.2K | 19.6K | 2.6K |
| 2020 | $172.17 | $55.81 | 3.08x | $116.36 | $631.0K | 16.7K | 2.6K |
| 2021 | $162.61 | $56.21 | 2.89x | $106.40 | $626.6K | 16.8K | 2.6K |
| 2022 | $166.70 | $57.32 | 2.91x | $109.38 | $530.3K | 14.4K | 2.5K |
| 2023 | $169.01 | $53.92 | 3.13x | $115.09 | $520.1K | 15.4K | 2.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 38.4K | $2.2M | $58.30 | 2.42x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 34.2K | $1.8M | $53.74 | 3.91x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 6.8K | $744.1K | $110.07 | 2.47x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 6.2K | $529.9K | $84.93 | 2.39x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.8K | $362.5K | $53.05 | 2.62x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.8K | $292.6K | $160.22 | 2.48x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.3K | $285.9K | $85.65 | 2.42x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 11.9K | $282.7K | $23.84 | 8.31x |
| 96366 | Infusion into a vein for therapy, prevention, or diagnosis | 8.9K | $139.6K | $15.75 | 12.38x |
| J1335 | Injection, ertapenem sodium, 500 mg | 4.2K | $129.3K | $31.01 | 2.76x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 622 | $79.3K | $127.49 | 2.53x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 748 | $63.1K | $84.36 | 2.49x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 5.5K | $55.8K | $10.20 | 2.16x |
| 36590 | Removal of peripheral venous catheter for infusion | 234 | $54.7K | $233.66 | 2.56x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 154 | $27.3K | $177.36 | 2.28x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 232 | $27.2K | $117.27 | 2.37x |
| J3370 | Injection, vancomycin hcl, 500 mg | 10.1K | $24.3K | $2.40 | 24.40x |
| 97597 | Removal of tissue from wounds per session | 1.0K | $20.8K | $20.57 | 6.93x |
| 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 | 467 | $19.6K | $42.00 | 4.19x |
| J0692 | Injection, cefepime hydrochloride, 500 mg | 11.0K | $17.9K | $1.63 | 38.74x |
This provider submits charges 3.64 times higher than what Medicare actually pays.
A markup ratio of 3.64x means for every $100 Medicare pays, this provider initially charges $364. 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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