This provider's $3.8M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 327% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 125% 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 | $110.51 | $64.54 | 1.71x | $45.97 | $228.9K | 3.6K | 1.6K |
| 2015 | $154.92 | $71.64 | 2.16x | $83.28 | $148.2K | 2.3K | 920 |
| 2016 | $157.75 | $79.27 | 1.99x | $78.48 | $333.6K | 5.2K | 1.4K |
| 2017 | $149.37 | $80.41 | 1.86x | $68.96 | $254.9K | 3.8K | 1.2K |
| 2018 | $141.12 | $76.12 | 1.85x | $65.00 | $291.3K | 4.3K | 1.5K |
| 2019 | $145.77 | $77.61 | 1.88x | $68.16 | $217.7K | 3.4K | 1.4K |
| 2020 | $124.09 | $68.83 | 1.80x | $55.26 | $383.2K | 6.1K | 2.0K |
| 2021 | $107.69 | $60.66 | 1.78x | $47.03 | $345.4K | 4.8K | 2.5K |
| 2022 | $108.12 | $56.95 | 1.90x | $51.17 | $623.7K | 8.2K | 5.3K |
| 2023 | $128.76 | $69.69 | 1.85x | $59.07 | $976.6K | 12.4K | 8.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 22.7K | $1.9M | $84.46 | 1.84x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 18.6K | $1.2M | $62.75 | 1.84x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 1.4K | $206.3K | $148.82 | 1.78x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 2.7K | $106.2K | $38.90 | 2.01x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 780 | $87.9K | $112.66 | 1.65x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 2.3K | $83.5K | $37.10 | 1.62x |
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 1.3K | $35.4K | $26.77 | 1.97x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 454 | $24.6K | $54.26 | 2.47x |
| 99316 | Nursing facility discharge management, more than 30 minutes | 252 | $24.0K | $95.27 | 1.87x |
| 97140 | Manual (physical) therapy techniques to 1 or more regions, each 15 minutes | 1.1K | $21.4K | $19.00 | 2.51x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 88 | $15.7K | $177.98 | 1.66x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 139 | $13.0K | $93.82 | 2.06x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 221 | $12.5K | $56.39 | 1.73x |
| 99457 | Remote physiologic monitoring treatment management services, health care professional time in a calendar month requiring interactive communication with the patient/caregiver; first 20 minutes | 279 | $11.3K | $40.44 | 1.85x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 174 | $11.1K | $63.56 | 1.58x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 137 | $9.6K | $70.32 | 1.59x |
| 99439 | Chronic care management services, each additional 20 minutes of clinical staff time per calendar month | 238 | $9.2K | $38.50 | 1.73x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 62 | $8.3K | $133.89 | 1.49x |
| G2058 | Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure). (do not report g2058 fo | 180 | $6.4K | $35.42 | 1.69x |
| 99238 | Hospital discharge day management, 30 minutes or less | 77 | $4.9K | $64.26 | 1.89x |
This provider submits charges 1.84 times higher than what Medicare actually pays.
A markup ratio of 1.84x means for every $100 Medicare pays, this provider initially charges $184. 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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