This provider's $6.1M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 2583% from 2015 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 565% in 2023
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 |
|---|---|---|---|---|---|---|---|
| 2015 | $118.77 | $75.44 | 1.57x | $43.33 | $156.4K | 2.1K | 13 |
| 2016 | $119.00 | $74.95 | 1.59x | $44.05 | $299.6K | 4.0K | 19 |
| 2017 | $226.53 | $71.40 | 3.17x | $155.13 | $262.0K | 3.7K | 22 |
| 2018 | $181.49 | $78.79 | 2.30x | $102.70 | $98.8K | 1.3K | 8 |
| 2019 | $181.49 | $89.95 | 2.02x | $91.54 | $89.1K | 991 | 9 |
| 2020 | $156.19 | $80.29 | 1.95x | $75.90 | $146.1K | 1.8K | 12 |
| 2021 | $129.79 | $66.29 | 1.96x | $63.50 | $265.4K | 4.0K | 15 |
| 2022 | $181.59 | $107.06 | 1.70x | $74.53 | $631.2K | 5.9K | 21 |
| 2023 | $362.44 | $262.23 | 1.38x | $100.21 | $4.2M | 16.0K | 30 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4236 | Carepatch, per square centimeter | 2.7K | $2.6M | $960.00 | 1.28x |
| Q4234 | Xcellerate, per square centimeter | 1.7K | $957.8K | $570.80 | 1.28x |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 4.7K | $272.6K | $57.94 | 1.92x |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 3.4K | $272.4K | $80.11 | 1.79x |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 2.9K | $262.0K | $89.67 | 1.88x |
| 99307 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes | 6.5K | $232.0K | $35.47 | 1.99x |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 1.2K | $202.9K | $163.40 | 2.37x |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 1.3K | $190.9K | $143.00 | 1.75x |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 1.3K | $189.0K | $141.66 | 1.86x |
| 11042 | Removal of skin and tissue first 20 sq cm or less | 2.3K | $173.4K | $74.40 | 2.42x |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 958 | $158.1K | $165.08 | 1.99x |
| 90694 | Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | 1.0K | $76.7K | $75.81 | 1.53x |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 1.2K | $74.5K | $61.28 | 1.92x |
| 11046 | Removal of muscle and/or tissue, each additional 20.0 sq cm or less | 1.3K | $69.6K | $52.02 | 2.67x |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 240 | $67.9K | $282.89 | 2.09x |
| 90480 | Admn sarscov2 vacc 1 dose | 1.4K | $59.2K | $43.09 | 1.39x |
| 17250 | Application of chemical to stop tissue regrowth in wound | 1.1K | $58.4K | $51.13 | 2.61x |
| G0008 | Administration of influenza virus vaccine | 1.5K | $47.2K | $32.24 | 1.11x |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 313 | $36.2K | $115.63 | 1.93x |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | 320 | $34.8K | $108.84 | 1.85x |
This provider submits charges 1.57 times higher than what Medicare actually pays.
A markup ratio of 1.57x means for every $100 Medicare pays, this provider initially charges $157. 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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