This provider's $5.6M 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 | $255.08 | $103.51 | 2.46x | $151.57 | $614.8K | 6.6K | 2.9K |
| 2015 | $313.63 | $146.67 | 2.14x | $166.96 | $631.7K | 6.1K | 2.6K |
| 2016 | $355.31 | $163.63 | 2.17x | $191.68 | $620.4K | 6.1K | 2.5K |
| 2017 | $367.70 | $127.78 | 2.88x | $239.92 | $599.8K | 5.5K | 2.6K |
| 2018 | $360.49 | $135.88 | 2.65x | $224.61 | $599.9K | 6.4K | 3.2K |
| 2019 | $364.10 | $147.94 | 2.46x | $216.16 | $638.6K | 6.4K | 3.2K |
| 2020 | $291.63 | $114.63 | 2.54x | $177.00 | $516.2K | 6.3K | 3.0K |
| 2021 | $284.36 | $117.61 | 2.42x | $166.75 | $485.8K | 5.5K | 2.5K |
| 2022 | $305.00 | $124.57 | 2.45x | $180.43 | $488.6K | 5.6K | 2.5K |
| 2023 | $300.41 | $122.58 | 2.45x | $177.83 | $397.7K | 4.8K | 2.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 18.1K | $1.2M | $65.74 | 2.37x |
| 95951 | Monitoring and localization of seizure activity over 24-hour period using 16-channel electroencephalograph (EEG) | 436 | $584.5K | $1.3K | 2.03x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.2K | $509.3K | $97.93 | 2.44x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 2.2K | $406.3K | $182.53 | 2.51x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 2.0K | $406.1K | $204.37 | 3.31x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 4.7K | $397.0K | $84.29 | 2.05x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.7K | $325.1K | $69.26 | 2.43x |
| 95816 | Measurement and recording of brain wave (EEG) activity, awake and drowsy | 838 | $243.3K | $290.33 | 2.27x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.4K | $222.7K | $93.21 | 2.00x |
| 95957 | Digital analysis of electrical brain wave activity (EEG) | 777 | $222.1K | $285.81 | 2.28x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 918 | $135.0K | $147.01 | 2.55x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 972 | $122.2K | $125.76 | 2.88x |
| 95911 | Nerve transmission studies, 9-10 studies | 576 | $121.6K | $211.11 | 3.05x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 821 | $120.3K | $146.55 | 1.54x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 2.2K | $80.9K | $37.47 | 2.57x |
| 99220 | Hospital observation care typically 70 minutes per day | 413 | $69.2K | $167.52 | 2.38x |
| 95886 | Needle measurement and recording of electrical activity of muscles of arm or leg complete study | 581 | $51.6K | $88.79 | 2.93x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 3.4K | $47.9K | $14.02 | 6.05x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 171 | $42.1K | $246.17 | 2.12x |
| 99239 | Hospital discharge day management, more than 30 minutes | 399 | $38.9K | $97.51 | 2.47x |
This provider submits charges 2.45 times higher than what Medicare actually pays.
A markup ratio of 2.45x means for every $100 Medicare pays, this provider initially charges $245. 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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