This provider's $5.2M in total Medicare payments ranks in the 99th percentile of Infectious Disease providers nationally.
Medicare payments to this provider grew 124% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 89% in 2022
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 | $225.79 | $78.84 | 2.86x | $146.95 | $378.3K | 5.4K | 1.8K |
| 2015 | $217.93 | $74.25 | 2.94x | $143.68 | $399.1K | 6.4K | 1.8K |
| 2016 | $212.23 | $72.28 | 2.94x | $139.95 | $400.9K | 6.4K | 1.7K |
| 2017 | $202.93 | $74.19 | 2.74x | $128.74 | $370.1K | 5.6K | 2.1K |
| 2018 | $175.38 | $70.31 | 2.49x | $105.07 | $506.8K | 7.1K | 3.0K |
| 2019 | $172.32 | $72.70 | 2.37x | $99.62 | $627.8K | 8.9K | 4.0K |
| 2020 | $174.09 | $69.10 | 2.52x | $104.99 | $368.4K | 5.2K | 2.1K |
| 2021 | $272.13 | $87.42 | 3.11x | $184.71 | $449.0K | 5.7K | 2.4K |
| 2022 | $296.52 | $87.67 | 3.38x | $208.85 | $848.4K | 9.7K | 4.2K |
| 2023 | $286.46 | $90.82 | 3.15x | $195.64 | $847.7K | 8.6K | 3.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 20.6K | $1.2M | $58.42 | 2.47x |
| 96521 | Refilling and maintenance of portable pump | 6.0K | $701.8K | $116.93 | 3.07x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 5.7K | $655.9K | $114.28 | 4.01x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 3.3K | $501.2K | $154.06 | 2.93x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 4.9K | $419.8K | $85.34 | 2.55x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 3.5K | $373.8K | $107.41 | 2.66x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.5K | $340.1K | $52.52 | 2.53x |
| 99239 | Hospital discharge day management, more than 30 minutes | 1.8K | $160.6K | $87.01 | 2.65x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.6K | $132.0K | $80.69 | 2.37x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 1.7K | $98.8K | $58.93 | 3.82x |
| 99238 | Hospital discharge day management, 30 minutes or less | 1.5K | $85.1K | $57.53 | 2.35x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 555 | $75.9K | $136.80 | 3.88x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 836 | $66.5K | $79.59 | 3.85x |
| 99316 | Nursing facility discharge management, more than 30 minutes | 546 | $50.7K | $92.91 | 3.85x |
| 99285 | Emergency department visit, problem with significant threat to life or function | 350 | $46.6K | $133.05 | 2.34x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 427 | $45.8K | $107.26 | 2.92x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 1.3K | $39.6K | $31.24 | 2.94x |
| 99284 | Emergency department visit, problem of high severity | 372 | $33.6K | $90.27 | 2.65x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 218 | $26.9K | $123.60 | 2.71x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 159 | $24.7K | $155.52 | 2.86x |
This provider submits charges 2.94 times higher than what Medicare actually pays.
A markup ratio of 2.94x means for every $100 Medicare pays, this provider initially charges $294. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data