This provider's $5.8M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 145% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 158% 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 | $101.40 | $44.71 | 2.27x | $56.69 | $519.8K | 13.8K | 8.5K |
| 2015 | $99.10 | $43.00 | 2.30x | $56.10 | $474.4K | 12.7K | 7.8K |
| 2016 | $97.56 | $43.98 | 2.22x | $53.58 | $436.0K | 12.3K | 7.9K |
| 2017 | $148.48 | $67.31 | 2.21x | $81.17 | $378.2K | 6.9K | 4.2K |
| 2018 | $152.18 | $60.19 | 2.53x | $91.99 | $339.4K | 6.0K | 3.6K |
| 2019 | $134.10 | $59.89 | 2.24x | $74.21 | $320.5K | 5.8K | 3.7K |
| 2020 | $140.31 | $62.12 | 2.26x | $78.19 | $277.4K | 4.7K | 2.7K |
| 2021 | $128.78 | $59.81 | 2.15x | $68.97 | $491.1K | 9.1K | 4.6K |
| 2022 | $141.43 | $66.51 | 2.13x | $74.92 | $1.3M | 18.5K | 7.4K |
| 2023 | $151.15 | $64.62 | 2.34x | $86.53 | $1.3M | 19.2K | 7.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99487 | Complex chronic care management services, first 60 minutes clinical staff time per calendar month | 9.6K | $894.8K | $93.69 | 1.66x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 4.6K | $743.6K | $162.54 | 1.62x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 8.5K | $502.2K | $59.07 | 1.61x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 4.6K | $391.2K | $85.14 | 1.58x |
| 99493 | Follow-up psychiatric collaborative care management, subsequent calendar month, first 60 minutes | 3.3K | $371.2K | $112.15 | 2.51x |
| 99489 | Complex chronic care management services, each additional 60 minutes clinical staff time per calendar month | 7.0K | $345.5K | $49.64 | 1.64x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.5K | $334.9K | $51.46 | 1.99x |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time per calendar month | 6.5K | $284.8K | $44.05 | 1.71x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 2.0K | $240.0K | $120.41 | 1.49x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.3K | $178.9K | $77.95 | 1.80x |
| 99239 | Hospital discharge day management, more than 30 minutes | 1.7K | $149.6K | $86.51 | 2.04x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 852 | $131.4K | $154.28 | 4.54x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 817 | $117.9K | $144.26 | 2.60x |
| 99494 | Psychiatric collaborative care management per calendar month, each additional 30 minutes | 2.5K | $117.5K | $46.92 | 2.31x |
| 99439 | Chronic care management services, each additional 20 minutes of clinical staff time per calendar month | 2.3K | $78.4K | $34.32 | 1.79x |
| 99238 | Hospital discharge day management, 30 minutes or less | 1.1K | $66.2K | $59.38 | 2.14x |
| 99492 | Initial psychiatric collaborative care management, first calendar month, first 70 minutes | 463 | $52.9K | $114.29 | 2.09x |
| 99219 | Hospital observation care typically 50 minutes | 357 | $38.0K | $106.36 | 2.12x |
| 76700 | Ultrasound of abdomen | 407 | $36.9K | $90.75 | 2.75x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 1.6K | $36.1K | $22.39 | 1.79x |
This provider submits charges 1.95 times higher than what Medicare actually pays.
A markup ratio of 1.95x means for every $100 Medicare pays, this provider initially charges $195. 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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