This provider's $6.8M in total Medicare payments ranks in the 99th percentile of Pulmonary Disease 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 | $157.15 | $72.40 | 2.17x | $84.75 | $600.2K | 8.7K | 6.5K |
| 2015 | $165.89 | $72.50 | 2.29x | $93.39 | $701.8K | 9.7K | 7.3K |
| 2016 | $184.84 | $83.30 | 2.22x | $101.54 | $871.6K | 11.5K | 8.9K |
| 2017 | $198.87 | $88.21 | 2.25x | $110.66 | $772.5K | 10.3K | 8.1K |
| 2018 | $203.63 | $97.53 | 2.09x | $106.10 | $762.8K | 10.5K | 8.1K |
| 2019 | $236.67 | $124.88 | 1.90x | $111.79 | $706.4K | 9.6K | 7.4K |
| 2020 | $206.09 | $103.73 | 1.99x | $102.36 | $564.0K | 7.9K | 6.4K |
| 2021 | $265.69 | $128.21 | 2.07x | $137.48 | $638.8K | 7.9K | 6.1K |
| 2022 | $249.25 | $127.31 | 1.96x | $121.94 | $624.9K | 8.2K | 6.3K |
| 2023 | $288.98 | $119.14 | 2.43x | $169.84 | $573.9K | 7.4K | 5.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 27.7K | $2.4M | $85.03 | 1.55x |
| 95811 | Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube | 2.6K | $1.2M | $481.06 | 1.91x |
| 95810 | Sleep monitoring of patient (6 years or older) in sleep lab | 1.6K | $697.6K | $449.77 | 2.01x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 4.0K | $495.1K | $124.42 | 1.74x |
| 94729 | Measurement of lung diffusing capacity | 8.5K | $343.6K | $40.34 | 1.60x |
| 94727 | Determination of lung volumes using gas dilution or washout | 8.5K | $264.3K | $31.02 | 2.20x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.2K | $190.0K | $160.06 | 1.45x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.1K | $176.5K | $82.62 | 1.49x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.4K | $135.6K | $55.47 | 1.54x |
| 94200 | Measurement of largest amount of air breathed in an out of lungs over one minute | 8.0K | $126.1K | $15.76 | 1.76x |
| 94250 | Single measurement of remaining air or lung capacity after exhalation | 5.8K | $109.7K | $18.91 | 1.69x |
| 94375 | Diagnostic testing in a pulmonary function lab | 3.6K | $102.1K | $28.44 | 1.55x |
| 94010 | Measurement and graphic recording of total and timed exhaled air capacity | 4.0K | $99.2K | $25.01 | 1.61x |
| 94617 | Exercise test for spasm of lung airways | 1.4K | $94.3K | $68.61 | 2.18x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 507 | $90.3K | $178.07 | 1.89x |
| 94060 | Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration | 1.9K | $77.0K | $40.53 | 1.59x |
| 94762 | Overnight measurement of oxygen saturation in blood using ear or finger device | 2.5K | $46.9K | $18.60 | 1.72x |
| 94620 | Pulmonary exercise testing | 1.2K | $38.0K | $32.86 | 2.85x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 1.1K | $16.8K | $14.88 | 1.75x |
| 31629 | Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope | 81 | $12.5K | $154.81 | 2.58x |
This provider submits charges 1.76 times higher than what Medicare actually pays.
A markup ratio of 1.76x means for every $100 Medicare pays, this provider initially charges $176. This is lower than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data