This provider's $4.5M in total Medicare payments ranks in the 99th percentile of Geriatric Medicine providers nationally.
Medicare payments to this provider grew 172% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 72% in 2020
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 | $146.26 | $42.90 | 3.41x | $103.36 | $272.4K | 5.6K | 2.4K |
| 2015 | $139.98 | $41.31 | 3.39x | $98.67 | $229.8K | 4.8K | 1.8K |
| 2016 | $146.47 | $45.07 | 3.25x | $101.40 | $307.3K | 5.7K | 2.2K |
| 2017 | $147.37 | $43.13 | 3.42x | $104.24 | $402.5K | 7.0K | 2.1K |
| 2018 | $160.68 | $45.73 | 3.51x | $114.95 | $456.4K | 7.9K | 2.4K |
| 2019 | $97.09 | $70.14 | 1.38x | $26.95 | $388.6K | 5.2K | 1.8K |
| 2020 | $100.27 | $73.29 | 1.37x | $26.98 | $666.5K | 8.6K | 2.3K |
| 2021 | $92.85 | $69.96 | 1.33x | $22.89 | $531.4K | 7.1K | 1.9K |
| 2022 | $104.89 | $72.12 | 1.45x | $32.77 | $531.7K | 7.4K | 2.5K |
| 2023 | $94.64 | $57.63 | 1.64x | $37.01 | $739.6K | 11.4K | 3.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 22.2K | $1.4M | $65.39 | 2.12x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 8.2K | $798.0K | $97.85 | 1.36x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 8.9K | $432.8K | $48.73 | 2.31x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 4.6K | $325.1K | $70.50 | 1.46x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 3.4K | $300.2K | $87.74 | 1.52x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 2.0K | $244.5K | $119.58 | 2.47x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.6K | $230.9K | $64.20 | 3.74x |
| 99348 | Established patient home visit, typically 25 minutes | 2.2K | $116.6K | $53.94 | 2.41x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.6K | $113.9K | $44.12 | 3.63x |
| 11042 | Removal of skin and tissue first 20 sq cm or less | 1.4K | $60.5K | $43.63 | 3.71x |
| 99327 | New patient assisted living visit, typically 60 minutes | 423 | $56.1K | $132.72 | 1.39x |
| 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 | 1.7K | $49.6K | $28.96 | 1.70x |
| 99334 | Established patient assisted living visit, typically 15 minutes | 1.2K | $43.7K | $37.77 | 3.56x |
| 99347 | Established patient home visit, typically 15 minutes | 1.1K | $40.1K | $37.25 | 3.57x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 415 | $36.1K | $87.03 | 3.72x |
| 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 | 719 | $27.5K | $38.25 | 1.73x |
| 99344 | Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes | 182 | $17.9K | $98.12 | 1.91x |
| 99457 | Management using the results of remote vital sign monitoring per calendar month, first 20 minutes | 445 | $16.2K | $36.43 | 1.70x |
| 99343 | New patient home visit, typically 45 minutes | 174 | $16.2K | $92.90 | 3.42x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 398 | $14.2K | $35.63 | 1.83x |
This provider submits charges 2.13 times higher than what Medicare actually pays.
A markup ratio of 2.13x means for every $100 Medicare pays, this provider initially charges $213. 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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