This provider's $3.9M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 495% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 110% in 2021
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 | $111.45 | $67.39 | 1.65x | $44.06 | $147.9K | 2.1K | 1.3K |
| 2015 | $115.40 | $67.37 | 1.71x | $48.03 | $194.8K | 2.8K | 1.9K |
| 2016 | $122.30 | $60.71 | 2.01x | $61.59 | $305.6K | 5.9K | 2.4K |
| 2017 | $124.38 | $65.47 | 1.90x | $58.91 | $305.1K | 5.7K | 3.0K |
| 2018 | $126.32 | $65.58 | 1.93x | $60.74 | $231.6K | 3.5K | 2.6K |
| 2019 | $122.95 | $59.93 | 2.05x | $63.02 | $219.3K | 3.1K | 2.3K |
| 2020 | $130.14 | $68.94 | 1.89x | $61.20 | $340.8K | 4.5K | 3.3K |
| 2021 | $181.40 | $81.09 | 2.24x | $100.31 | $716.3K | 9.9K | 5.2K |
| 2022 | $196.48 | $82.26 | 2.39x | $114.22 | $596.0K | 9.6K | 4.8K |
| 2023 | $165.60 | $76.64 | 2.16x | $88.96 | $880.8K | 11.1K | 7.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 11.8K | $993.9K | $83.89 | 3.02x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 4.2K | $577.0K | $138.11 | 1.32x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.0K | $418.1K | $59.31 | 2.97x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 3.6K | $319.8K | $89.98 | 1.11x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 4.8K | $230.0K | $48.37 | 2.81x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 2.0K | $226.9K | $111.46 | 2.69x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 5.1K | $166.0K | $32.77 | 1.41x |
| 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 | 3.2K | $143.3K | $45.40 | 3.51x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.0K | $114.8K | $112.09 | 2.90x |
| 93922 | Ultrasound study of arteries of both arms and legs, limited | 1.3K | $93.9K | $72.38 | 4.12x |
| 99458 | Remote physiologic monitoring treatment management services, health care professional time in a calendar month requiring interactive communication with the patient/caregiver; each additional 20 minute | 2.1K | $77.7K | $36.76 | 5.21x |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 393 | $73.7K | $187.53 | 1.09x |
| 90662 | Vaccine for influenza for injection into muscle | 1.3K | $66.7K | $52.88 | 1.05x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 371 | $59.0K | $158.97 | 2.25x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 190 | $45.5K | $239.51 | 1.64x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 228 | $42.5K | $186.54 | 1.09x |
| G0008 | Administration of influenza virus vaccine | 1.5K | $40.3K | $26.42 | 1.28x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 516 | $40.0K | $77.60 | 3.30x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 3.2K | $39.1K | $12.40 | 5.55x |
| 95923 | Testing of autonomic (sympathetic) nervous system function | 297 | $32.5K | $109.59 | 3.44x |
This provider submits charges 2.47 times higher than what Medicare actually pays.
A markup ratio of 2.47x means for every $100 Medicare pays, this provider initially charges $247. 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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