This provider's $4.0M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Their average markup ratio of 16.01x is significantly above the specialty median of 2.9x.
Medicare payments to this provider grew 233% from 2014 to 2023.
64% of their billing comes from a single procedure code (99233 — Subsequent hospital inpatient care, typically 35 minutes per day).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 67% in 2018
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 | $1.5K | $116.46 | 12.86x | $1.4K | $259.5K | 2.3K | 658 |
| 2015 | $1.7K | $125.50 | 13.32x | $1.5K | $218.5K | 2.0K | 769 |
| 2016 | $1.7K | $124.89 | 13.38x | $1.5K | $161.2K | 1.6K | 614 |
| 2017 | $1.6K | $114.23 | 13.79x | $1.5K | $190.0K | 1.9K | 712 |
| 2018 | $1.6K | $120.08 | 13.49x | $1.5K | $317.4K | 3.1K | 1.1K |
| 2019 | $1.5K | $105.44 | 14.51x | $1.4K | $312.1K | 3.1K | 1.1K |
| 2020 | $1.8K | $114.74 | 15.69x | $1.7K | $397.9K | 4.0K | 1.2K |
| 2021 | $1.8K | $118.94 | 15.13x | $1.7K | $563.3K | 5.5K | 1.5K |
| 2022 | $1.6K | $104.88 | 14.95x | $1.5K | $731.0K | 7.3K | 2.0K |
| 2023 | $1.4K | $102.45 | 13.66x | $1.3K | $863.9K | 8.4K | 2.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 28.2K | $2.6M | $90.65 | 17.16x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 5.4K | $887.5K | $165.83 | 11.56x |
| 99239 | Hospital discharge day management, more than 30 minutes | 3.8K | $351.7K | $92.32 | 20.75x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 727 | $136.9K | $188.31 | 13.19x |
| 99497 | Advance care planning, first 30 minutes | 887 | $56.6K | $63.78 | 13.80x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 95 | $11.4K | $120.42 | 7.43x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 64 | $5.9K | $91.47 | 7.71x |
| 99220 | Hospital observation care typically 70 minutes per day | 24 | $3.7K | $156.13 | 9.99x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 18 | $2.5K | $139.61 | 12.89x |
| 99217 | Hospital observation care discharge | 34 | $2.1K | $61.55 | 21.45x |
| 99238 | Hospital discharge day management, 30 minutes or less | 28 | $1.7K | $62.17 | 21.23x |
This provider submits charges 16.01 times higher than what Medicare actually pays.
A markup ratio of 16.01x means for every $100 Medicare pays, this provider initially charges $1601. 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