This provider's $4.5M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 107% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 53% in 2018
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 | $88.46 | $55.84 | 1.58x | $32.62 | $277.4K | 6.7K | 1.5K |
| 2015 | $75.85 | $41.93 | 1.81x | $33.92 | $254.4K | 5.7K | 998 |
| 2016 | $98.34 | $52.19 | 1.88x | $46.15 | $369.4K | 5.5K | 1.7K |
| 2017 | $113.20 | $48.68 | 2.33x | $64.52 | $296.3K | 5.2K | 1.5K |
| 2018 | $104.61 | $44.85 | 2.33x | $59.76 | $452.9K | 8.4K | 2.5K |
| 2019 | $116.07 | $53.16 | 2.18x | $62.91 | $520.3K | 8.8K | 2.5K |
| 2020 | $111.77 | $52.71 | 2.12x | $59.06 | $614.8K | 9.6K | 2.7K |
| 2021 | $114.97 | $58.85 | 1.95x | $56.12 | $608.4K | 9.0K | 2.6K |
| 2022 | $124.19 | $61.65 | 2.01x | $62.54 | $531.8K | 9.0K | 2.8K |
| 2023 | $117.95 | $55.91 | 2.11x | $62.04 | $575.3K | 10.6K | 2.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 11.7K | $1.1M | $93.38 | 1.95x |
| 99350 | Established patient home visit, typically 60 minutes | 6.9K | $1.0M | $147.63 | 1.84x |
| 99349 | Established patient home visit, typically 40 minutes | 6.0K | $635.2K | $105.11 | 1.92x |
| 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 | 7.0K | $305.4K | $43.68 | 1.93x |
| 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 | 6.7K | $224.8K | $33.79 | 1.92x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 4.8K | $192.9K | $40.29 | 2.10x |
| 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 | 1.6K | $143.3K | $88.00 | 1.88x |
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 5.4K | $118.2K | $21.99 | 3.07x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 789 | $104.1K | $131.96 | 1.68x |
| 97140 | Manual (physical) therapy techniques to 1 or more regions, each 15 minutes | 5.6K | $98.7K | $17.63 | 3.92x |
| 99407 | Smoking and tobacco use intensive counseling, greater than 10 minutes | 2.9K | $82.9K | $28.91 | 1.65x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.2K | $79.1K | $63.95 | 2.16x |
| 99344 | New patient home visit, typically 60 minutes | 434 | $62.1K | $143.11 | 1.87x |
| 97032 | Application of electrical stimulation to 1 or more areas, each 15 minutes | 5.0K | $51.3K | $10.20 | 7.32x |
| 99348 | Established patient home visit, typically 25 minutes | 613 | $40.3K | $65.71 | 2.07x |
| 99345 | New patient home visit, typically 75 minutes | 167 | $28.8K | $172.38 | 1.72x |
| 99457 | Remote physiologic monitoring treatment management services, health care professional time in a calendar month requiring interactive communication with the patient/caregiver; first 20 minutes | 657 | $27.1K | $41.23 | 1.84x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 587 | $25.5K | $43.37 | 2.19x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 1.8K | $25.2K | $13.74 | 3.37x |
| G0437 | Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes | 826 | $24.1K | $29.17 | 1.71x |
This provider submits charges 2.07 times higher than what Medicare actually pays.
A markup ratio of 2.07x means for every $100 Medicare pays, this provider initially charges $207. 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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