This provider's $6.7M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 4298% from 2014 to 2023.
77% of their billing comes from a single procedure code (Q4205 — Membrane graft or membrane wrap, per square centimeter).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 5872% in 2023
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 | $161.35 | $65.16 | 2.48x | $96.19 | $128.6K | 2.0K | 21 |
| 2015 | $203.41 | $64.24 | 3.17x | $139.17 | $98.3K | 1.5K | 17 |
| 2016 | $209.37 | $63.28 | 3.31x | $146.09 | $101.3K | 1.6K | 15 |
| 2017 | $206.46 | $57.40 | 3.60x | $149.06 | $131.0K | 2.3K | 20 |
| 2018 | $209.09 | $58.17 | 3.59x | $150.92 | $128.3K | 2.2K | 20 |
| 2019 | $228.51 | $58.64 | 3.90x | $169.87 | $117.0K | 2.0K | 19 |
| 2020 | $217.55 | $59.62 | 3.65x | $157.93 | $120.5K | 2.0K | 16 |
| 2021 | $255.26 | $74.90 | 3.41x | $180.36 | $146.4K | 2.0K | 16 |
| 2022 | $230.71 | $69.81 | 3.30x | $160.90 | $94.7K | 1.4K | 15 |
| 2023 | $897.55 | $682.47 | 1.32x | $215.08 | $5.7M | 8.3K | 19 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4205 | Membrane graft or membrane wrap, per square centimeter | 4.4K | $5.1M | $1.2K | 1.29x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 4.9K | $365.3K | $74.76 | 3.26x |
| A2001 | Innovamatrix ac, per square centimeter | 330 | $266.5K | $807.52 | 1.28x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 3.5K | $171.5K | $48.61 | 3.58x |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 2.7K | $165.7K | $61.92 | 3.69x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 981 | $102.2K | $104.22 | 3.05x |
| 0598T | Fluorescence wound imaging for bacteria, first anatomic site | 871 | $96.3K | $110.52 | 1.61x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 755 | $90.8K | $120.23 | 2.44x |
| 97610 | Therapy procedure using ultrasound | 148 | $48.7K | $329.34 | 1.52x |
| 97597 | Removal of tissue from wound, 20.0 sq cm or less | 961 | $30.0K | $31.18 | 5.55x |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 205 | $29.6K | $144.33 | 2.73x |
| 15271 | Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less | 270 | $29.2K | $108.17 | 2.05x |
| 90670 | Pneumococcal vaccine for injection into muscle | 121 | $20.9K | $172.33 | 2.11x |
| 90662 | Vaccine for influenza for injection into muscle, split virus, preservation free | 378 | $18.9K | $49.89 | 1.88x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 208 | $16.9K | $81.19 | 2.36x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 84 | $16.4K | $195.77 | 3.09x |
| 0599T | Fluorescence wound imaging for bacteria, each additional anatomic site | 198 | $14.9K | $75.49 | 1.47x |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 470 | $14.9K | $31.69 | 4.45x |
| G0181 | Physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of c | 170 | $14.6K | $85.80 | 3.04x |
| 99204 | New patient outpatient visit, total time 45-59 minutes | 132 | $13.9K | $104.95 | 3.71x |
This provider submits charges 1.64 times higher than what Medicare actually pays.
A markup ratio of 1.64x means for every $100 Medicare pays, this provider initially charges $164. 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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