This provider's $4.6M in total Medicare payments ranks in the 99th percentile of Infectious Disease providers nationally.
Medicare payments to this provider grew 475% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 140% 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 | $283.62 | $83.07 | 3.41x | $200.55 | $149.4K | 2.0K | 1.2K |
| 2015 | $286.00 | $85.25 | 3.35x | $200.75 | $136.7K | 1.7K | 1.1K |
| 2016 | $190.83 | $68.13 | 2.80x | $122.70 | $156.2K | 2.1K | 1.1K |
| 2017 | $151.52 | $69.12 | 2.19x | $82.40 | $222.0K | 3.1K | 1.4K |
| 2018 | $129.22 | $61.58 | 2.10x | $67.64 | $249.4K | 3.4K | 1.7K |
| 2019 | $148.94 | $70.63 | 2.11x | $78.31 | $257.0K | 3.4K | 1.7K |
| 2020 | $101.92 | $48.45 | 2.10x | $53.47 | $617.1K | 12.8K | 2.7K |
| 2021 | $158.20 | $76.52 | 2.07x | $81.68 | $1.0M | 21.1K | 3.7K |
| 2022 | $301.87 | $141.85 | 2.13x | $160.02 | $959.8K | 17.0K | 3.7K |
| 2023 | $188.62 | $52.18 | 3.61x | $136.44 | $858.9K | 14.4K | 3.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 12.2K | $1.0M | $85.96 | 2.22x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 12.0K | $689.4K | $57.68 | 2.18x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 10.6K | $566.6K | $53.34 | 2.81x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 3.6K | $565.4K | $157.02 | 2.33x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.0K | $554.7K | $92.92 | 2.42x |
| 11042 | Removal of skin and tissue first 20 sq cm or less | 2.0K | $196.9K | $98.43 | 2.89x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 1.0K | $168.5K | $168.49 | 3.08x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 5.8K | $138.3K | $23.81 | 3.25x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 1.0K | $106.6K | $104.08 | 2.58x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.6K | $86.2K | $55.40 | 2.20x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 550 | $68.6K | $124.66 | 2.72x |
| J1335 | Injection, ertapenem sodium, 500 mg | 3.5K | $65.2K | $18.65 | 5.50x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 487 | $54.1K | $111.11 | 2.22x |
| Q0222 | Injection, bebtelovimab, 175 mg | 23 | $54.0K | $2.3K | 2.04x |
| 96368 | Infusion into a vein for therapy, prevention, or diagnosis, concurrent with another infusion | 2.4K | $38.4K | $15.83 | 2.74x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 194 | $29.0K | $149.56 | 2.44x |
| M0222 | Intravenous injection, bebtelovimab, includes injection and post administration monitoring | 85 | $27.7K | $325.60 | 2.15x |
| 97597 | Removal of tissue from wounds per session, first 20 sq cms or less | 328 | $25.4K | $77.46 | 2.30x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 697 | $21.6K | $31.05 | 2.50x |
| M0243 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring | 38 | $16.3K | $428.82 | 2.10x |
This provider submits charges 2.5 times higher than what Medicare actually pays.
A markup ratio of 2.5x means for every $100 Medicare pays, this provider initially charges $250. 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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