This provider averages 55 services per working day
Based on 95.4K total services over 7 years (250 working days/year). Learn about impossible service volumes →
This provider's $4.2M in total Medicare payments ranks in the 99th percentile of Hospitalist providers nationally.
Averaging 55 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 2138% from 2017 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 605% in 2019
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 |
|---|---|---|---|---|---|---|---|
| 2017 | $551.12 | $121.43 | 4.54x | $429.69 | $30.5K | 330 | 229 |
| 2018 | $166.23 | $36.76 | 4.52x | $129.47 | $139.6K | 4.2K | 3.3K |
| 2019 | $391.03 | $96.06 | 4.07x | $294.97 | $984.6K | 22.5K | 6.3K |
| 2020 | $462.16 | $99.64 | 4.64x | $362.52 | $826.4K | 19.3K | 6.6K |
| 2021 | $442.72 | $84.39 | 5.25x | $358.33 | $842.9K | 16.6K | 5.6K |
| 2022 | $269.61 | $60.51 | 4.46x | $209.10 | $729.4K | 15.0K | 5.4K |
| 2023 | $240.32 | $50.65 | 4.74x | $189.67 | $682.4K | 17.5K | 7.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 9.2K | $993.2K | $107.49 | 3.86x |
| J2505 | Injection, pegfilgrastim, 6 mg | 172 | $546.0K | $3.2K | 4.43x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 3.4K | $346.0K | $100.44 | 3.76x |
| J1454 | Injection, fosnetupitant 235 mg and palonosetron 0.25 mg | 858 | $317.2K | $369.75 | 4.78x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 2.2K | $308.1K | $138.60 | 3.65x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.9K | $301.0K | $155.70 | 6.01x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 4.9K | $226.0K | $46.25 | 2.83x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 908 | $136.2K | $149.96 | 3.27x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 648 | $117.5K | $181.34 | 3.12x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 14.3K | $113.1K | $7.89 | 13.59x |
| 80053 | Blood test, comprehensive group of blood chemicals | 6.2K | $67.6K | $10.95 | 4.92x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 942 | $63.8K | $67.75 | 7.30x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 742 | $57.6K | $77.68 | 2.83x |
| 36415 | Insertion of needle into vein for collection of blood sample | 14.9K | $56.5K | $3.80 | 5.53x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 748 | $50.6K | $67.65 | 4.42x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 1.4K | $41.9K | $29.68 | 3.05x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 629 | $41.8K | $66.42 | 3.20x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 196 | $40.7K | $207.44 | 3.74x |
| 99195 | Therapeutic removal of whole blood to correct blood level imbalance | 306 | $29.7K | $97.03 | 3.90x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 2.1K | $29.6K | $14.07 | 13.51x |
This provider submits charges 4.63 times higher than what Medicare actually pays.
A markup ratio of 4.63x means for every $100 Medicare pays, this provider initially charges $463. 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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