This provider's $4.8M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 152% from 2014 to 2023.
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 | $129.03 | $57.74 | 2.23x | $71.29 | $313.3K | 5.6K | 2.4K |
| 2015 | $126.87 | $57.78 | 2.20x | $69.09 | $293.3K | 6.2K | 2.5K |
| 2016 | $144.17 | $52.68 | 2.74x | $91.49 | $305.9K | 6.8K | 2.8K |
| 2017 | $138.38 | $51.92 | 2.67x | $86.46 | $307.0K | 7.1K | 3.1K |
| 2018 | $143.44 | $55.76 | 2.57x | $87.68 | $413.3K | 10.6K | 4.2K |
| 2019 | $167.81 | $67.46 | 2.49x | $100.35 | $493.1K | 12.5K | 4.5K |
| 2020 | $148.95 | $60.03 | 2.48x | $88.92 | $544.4K | 12.5K | 4.7K |
| 2021 | $164.71 | $68.97 | 2.39x | $95.74 | $626.7K | 11.4K | 4.2K |
| 2022 | $139.39 | $58.27 | 2.39x | $81.12 | $677.8K | 13.2K | 4.3K |
| 2023 | $144.33 | $58.18 | 2.48x | $86.15 | $788.7K | 15.1K | 4.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 29.0K | $2.0M | $70.26 | 2.27x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.5K | $331.5K | $94.68 | 2.43x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 2.1K | $278.0K | $133.96 | 1.87x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.7K | $234.0K | $87.99 | 2.37x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 2.6K | $159.1K | $61.21 | 2.30x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 845 | $141.4K | $167.33 | 2.30x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 8.5K | $132.8K | $15.58 | 3.53x |
| 17000 | Destruction of skin growth | 2.1K | $124.8K | $58.32 | 2.44x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 3.6K | $122.4K | $34.32 | 2.62x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 1.6K | $112.4K | $70.40 | 2.84x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 2.2K | $96.7K | $43.41 | 2.17x |
| 96116 | Neurobehavioral status examination, interpretation, and report by psychologist or physician per hour | 1.0K | $82.3K | $81.84 | 2.44x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 303 | $72.1K | $237.83 | 1.72x |
| 69210 | Removal of impact ear wax, one ear | 1.8K | $71.2K | $40.53 | 2.78x |
| 99239 | Hospital discharge day management, more than 30 minutes | 771 | $70.6K | $91.52 | 2.29x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 353 | $65.8K | $186.26 | 2.48x |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 2.2K | $62.6K | $27.91 | 2.04x |
| G0446 | Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes | 1.9K | $53.0K | $28.34 | 1.76x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 672 | $51.5K | $76.65 | 2.49x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 972 | $44.8K | $46.13 | 2.93x |
This provider submits charges 2.38 times higher than what Medicare actually pays.
A markup ratio of 2.38x means for every $100 Medicare pays, this provider initially charges $238. 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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