This provider's $3.5M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 914% from 2016 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 111% in 2017
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 |
|---|---|---|---|---|---|---|---|
| 2016 | $218.90 | $85.58 | 2.56x | $133.32 | $80.5K | 931 | 819 |
| 2017 | $214.41 | $78.06 | 2.75x | $136.35 | $169.7K | 2.2K | 1.7K |
| 2018 | $254.23 | $89.96 | 2.83x | $164.27 | $183.5K | 2.4K | 1.6K |
| 2019 | $261.74 | $110.87 | 2.36x | $150.87 | $311.8K | 3.4K | 2.0K |
| 2020 | $266.98 | $110.13 | 2.42x | $156.85 | $504.9K | 8.3K | 2.5K |
| 2021 | $279.04 | $121.39 | 2.30x | $157.65 | $895.3K | 12.0K | 5.1K |
| 2022 | $301.87 | $111.18 | 2.72x | $190.69 | $559.2K | 8.9K | 5.3K |
| 2023 | $339.68 | $127.01 | 2.67x | $212.67 | $815.8K | 15.5K | 4.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 20.7K | $845.3K | $40.89 | 2.36x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 7.4K | $609.4K | $82.62 | 2.31x |
| 95811 | Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube | 1.1K | $440.7K | $418.93 | 2.34x |
| 95810 | Sleep monitoring of patient (6 years or older) in sleep lab | 1.1K | $440.2K | $415.30 | 2.41x |
| 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 | 9.2K | $338.5K | $36.79 | 2.62x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.9K | $230.9K | $119.14 | 2.04x |
| 94660 | Initiation and management of continued pressured respiratory assistance by mask or breathing tube | 3.2K | $147.1K | $45.76 | 2.42x |
| 95800 | Study of sleep patterns | 1.1K | $113.5K | $107.65 | 2.73x |
| 99091 | Collection and interpretation of physical parameters stored in computers and/or transmitted by the patient and/or caregiver to qualified health care professional, requiring 30 minutes or more, per 30 days | 1.8K | $79.8K | $43.51 | 2.13x |
| 99487 | Complex chronic care management services 60 minutes clinical staff time | 931 | $62.7K | $67.29 | 3.87x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 669 | $51.2K | $76.50 | 2.27x |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 1.6K | $39.6K | $25.45 | 4.52x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 664 | $38.3K | $57.73 | 2.16x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 256 | $33.8K | $131.99 | 2.49x |
| 99453 | Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment | 1.5K | $21.0K | $14.26 | 2.56x |
| 99489 | Complex chronic care management services each additional 30 minutes clinical staff time | 600 | $19.9K | $33.20 | 5.79x |
| 99205 | New patient outpatient visit, total time 60-74 minutes | 15 | $2.3K | $154.27 | 2.03x |
| 94690 | Collection and analysis of exhaled air for evaluation of lung function at rest | 44 | $1.4K | $32.48 | 3.14x |
| G0399 | Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation | 17 | $1.3K | $77.90 | 4.49x |
| 95806 | Unattended sleep study with recording of heart rate, oxygen, respiratory airflow and effort | 15 | $1.2K | $76.95 | 3.90x |
This provider submits charges 2.44 times higher than what Medicare actually pays.
A markup ratio of 2.44x means for every $100 Medicare pays, this provider initially charges $244. 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