⚠️ This provider averages 2.1K services per working day — physically unusual for an individual practitioner
Based on 3.6M total services over 7 years (250 working days/year). Learn about impossible service volumes →
This provider's $19.8M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Averaging 2.1K services per working day raises questions about billing patterns.
Medicare payments to this provider grew 31115% from 2017 to 2023.
89% of their billing comes from a single procedure code (J0585 — Injection, onabotulinumtoxina, 1 unit).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 385% 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 |
|---|---|---|---|---|---|---|---|
| 2017 | $6.76 | $5.17 | 1.31x | $1.59 | $28.0K | 5.4K | 1 |
| 2018 | $7.06 | $5.28 | 1.34x | $1.78 | $136.1K | 25.8K | 3 |
| 2019 | $6.77 | $5.14 | 1.32x | $1.63 | $353.5K | 68.7K | 1 |
| 2020 | $7.36 | $5.29 | 1.39x | $2.07 | $742.6K | 140.3K | 1 |
| 2021 | $6.94 | $5.39 | 1.29x | $1.55 | $3.1M | 583.1K | 3 |
| 2022 | $7.13 | $5.43 | 1.31x | $1.70 | $6.6M | 1.2M | 2 |
| 2023 | $7.22 | $5.53 | 1.31x | $1.69 | $8.8M | 1.6M | 1 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0585 | Injection, onabotulinumtoxina, 1 unit | 3.6M | $17.5M | $4.86 | 1.29x |
| 64615 | Injection of chemical for paralysis of facial and neck nerve muscles on both sides of face | 17.9K | $2.2M | $124.62 | 1.46x |
| 99214 | Established patient outpatient visit, total time 30-39 minutes | 68 | $5.8K | $85.08 | 2.47x |
| 99354 | Prolonged office or other outpatient service first hour | 22 | $2.3K | $102.71 | 1.95x |
This provider submits charges 1.31 times higher than what Medicare actually pays.
A markup ratio of 1.31x means for every $100 Medicare pays, this provider initially charges $131. 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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