This provider's $3.8M in total Medicare payments ranks in the 99th percentile of Critical Care (Intensivists) providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
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 | $200.55 | $84.26 | 2.38x | $116.29 | $300.8K | 3.8K | 2.3K |
| 2015 | $205.44 | $79.94 | 2.57x | $125.50 | $320.7K | 3.9K | 2.7K |
| 2016 | $270.64 | $100.59 | 2.69x | $170.05 | $358.0K | 4.4K | 3.0K |
| 2017 | $324.20 | $99.34 | 3.26x | $224.86 | $471.4K | 5.8K | 4.0K |
| 2018 | $339.30 | $98.41 | 3.45x | $240.89 | $482.0K | 5.8K | 4.0K |
| 2019 | $319.90 | $104.75 | 3.05x | $215.15 | $362.0K | 4.7K | 3.2K |
| 2020 | $215.96 | $77.27 | 2.79x | $138.69 | $303.9K | 4.0K | 2.9K |
| 2021 | $275.44 | $107.24 | 2.57x | $168.20 | $341.2K | 4.0K | 2.7K |
| 2022 | $291.54 | $105.98 | 2.75x | $185.56 | $371.4K | 4.3K | 3.0K |
| 2023 | $265.48 | $95.23 | 2.79x | $170.25 | $440.4K | 5.3K | 3.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 13.5K | $1.1M | $84.64 | 1.57x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 2.2K | $397.9K | $177.41 | 2.78x |
| 95810 | Sleep monitoring of patient (6 years or older) in sleep lab | 722 | $334.5K | $463.26 | 3.08x |
| 95811 | Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube | 650 | $323.8K | $498.09 | 2.92x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 4.1K | $239.4K | $58.37 | 2.49x |
| 94729 | Measurement of lung diffusing capacity | 4.1K | $156.3K | $38.27 | 2.24x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 876 | $135.9K | $155.10 | 1.61x |
| 94726 | Determination of lung volumes using plethysmography | 3.6K | $132.4K | $36.96 | 2.32x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 1.1K | $120.8K | $106.15 | 2.35x |
| 94660 | Initiation and management of continued pressured respiratory assistance by mask or breathing tube | 2.4K | $112.4K | $47.72 | 3.93x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 627 | $98.7K | $157.42 | 1.73x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.1K | $93.1K | $87.28 | 3.70x |
| 94010 | Measurement and graphic recording of total and timed exhaled air capacity | 3.9K | $91.9K | $23.56 | 3.32x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 515 | $64.4K | $125.11 | 1.60x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 481 | $54.0K | $112.23 | 1.39x |
| 99292 | Critical care delivery critically ill or injured patient | 322 | $28.8K | $89.55 | 2.55x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 523 | $28.8K | $55.08 | 1.71x |
| 99091 | Collection and interpretation of physical parameters stored in computers minimum of 30 minutes | 431 | $19.1K | $44.28 | 1.62x |
| 94618 | Test for exercise-induced lung stress | 715 | $18.8K | $26.23 | 1.99x |
| 94060 | Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration | 452 | $15.9K | $35.10 | 3.49x |
This provider submits charges 2.36 times higher than what Medicare actually pays.
A markup ratio of 2.36x means for every $100 Medicare pays, this provider initially charges $236. 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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