This provider averages 53 services per working day
Based on 118.2K total services over 9 years (250 working days/year). Learn about impossible service volumes →
This provider's $10.9M in total Medicare payments ranks in the 99th percentile of Preventive Medicine providers nationally.
Averaging 53 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 718% from 2015 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 234% in 2017
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 |
|---|---|---|---|---|---|---|---|
| 2015 | $203.17 | $109.97 | 1.85x | $93.20 | $173.0K | 1.6K | 1.2K |
| 2016 | $237.66 | $121.72 | 1.95x | $115.94 | $300.3K | 2.8K | 2.1K |
| 2017 | $214.66 | $118.43 | 1.81x | $96.23 | $1.0M | 10.2K | 6.5K |
| 2018 | $188.56 | $113.62 | 1.66x | $74.94 | $1.7M | 18.8K | 10.2K |
| 2019 | $178.79 | $108.11 | 1.65x | $70.68 | $1.2M | 13.9K | 7.3K |
| 2020 | $165.76 | $106.68 | 1.55x | $59.08 | $1.9M | 20.0K | 10.1K |
| 2021 | $156.69 | $107.09 | 1.46x | $49.60 | $1.8M | 19.7K | 8.7K |
| 2022 | $165.29 | $105.71 | 1.56x | $59.58 | $1.3M | 15.0K | 6.8K |
| 2023 | $156.75 | $96.19 | 1.63x | $60.56 | $1.4M | 16.2K | 6.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 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 | 59.5K | $5.4M | $90.35 | 1.76x |
| 99350 | Established patient home visit, typically 60 minutes | 12.8K | $1.9M | $149.64 | 1.74x |
| 99345 | New patient home visit, typically 75 minutes | 5.7K | $1.0M | $178.65 | 1.86x |
| G0180 | Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple | 12.7K | $589.7K | $46.27 | 1.76x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 2.8K | $515.3K | $181.97 | 1.49x |
| G0179 | Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial im | 13.2K | $473.5K | $35.81 | 1.77x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 5.2K | $396.8K | $76.88 | 1.61x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 3.0K | $392.4K | $132.51 | 1.40x |
| G0108 | Diabetes outpatient self-management training services, individual, per 30 minutes | 2.7K | $128.3K | $47.61 | 1.69x |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 184 | $33.1K | $179.96 | 1.42x |
| 99328 | New patient assisted living visit, typically 75 minutes | 95 | $17.3K | $182.31 | 1.76x |
| 99407 | Smoking and tobacco use intensive counseling, greater than 10 minutes | 304 | $9.2K | $30.34 | 1.36x |
| 99344 | New patient home visit, typically 60 minutes | 36 | $5.4K | $150.58 | 2.06x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 15 | $2.4K | $161.91 | 1.76x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 11 | $2.1K | $193.87 | 1.99x |
This provider submits charges 1.73 times higher than what Medicare actually pays.
A markup ratio of 1.73x means for every $100 Medicare pays, this provider initially charges $173. 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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