This provider averages 70 services per working day
Based on 175.3K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $9.4M in total Medicare payments ranks in the 99th percentile of Pulmonary Disease providers nationally.
Averaging 70 services per working day raises questions about billing patterns.
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 | $153.67 | $55.03 | 2.79x | $98.64 | $1.1M | 20.3K | 10.4K |
| 2015 | $170.80 | $60.93 | 2.80x | $109.87 | $981.5K | 18.9K | 9.4K |
| 2016 | $182.67 | $57.01 | 3.20x | $125.66 | $962.2K | 17.5K | 8.6K |
| 2017 | $158.74 | $49.62 | 3.20x | $109.12 | $1.1M | 21.2K | 9.0K |
| 2018 | $145.05 | $49.23 | 2.95x | $95.82 | $1.1M | 21.4K | 9.2K |
| 2019 | $150.34 | $49.57 | 3.03x | $100.77 | $1.1M | 20.6K | 9.2K |
| 2020 | $164.61 | $55.72 | 2.95x | $108.89 | $929.4K | 16.2K | 7.7K |
| 2021 | $181.13 | $60.16 | 3.01x | $120.97 | $883.8K | 15.0K | 6.9K |
| 2022 | $140.23 | $46.53 | 3.01x | $93.70 | $815.5K | 15.1K | 6.5K |
| 2023 | $133.85 | $47.32 | 2.83x | $86.53 | $506.3K | 9.2K | 4.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 22.4K | $1.7M | $77.74 | 1.93x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 15.9K | $1.7M | $105.20 | 2.10x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 10.0K | $835.2K | $83.67 | 1.70x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 3.8K | $569.9K | $149.65 | 1.80x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 7.6K | $417.4K | $54.93 | 2.19x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 2.2K | $314.5K | $144.71 | 1.90x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 5.4K | $295.9K | $54.74 | 1.84x |
| 94060 | Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration | 6.9K | $261.8K | $38.16 | 2.34x |
| 87633 | Detection test for multiple types of respiratory virus | 564 | $250.0K | $443.30 | 1.47x |
| 94729 | Measurement of lung diffusing capacity | 6.2K | $242.4K | $38.84 | 2.17x |
| 71046 | X-ray of chest, 2 views | 9.9K | $231.4K | $23.34 | 1.92x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 1.4K | $230.1K | $165.38 | 2.09x |
| 94726 | Determination of lung volumes using plethysmography | 5.8K | $215.9K | $37.21 | 2.66x |
| J2357 | Injection, omalizumab, 5 mg | 7.6K | $206.4K | $27.11 | 1.59x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 3.4K | $172.5K | $50.28 | 1.88x |
| 32555 | Removal of fluid from chest cavity with imaging guidance | 995 | $164.4K | $165.20 | 5.02x |
| 95811 | Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube | 1.6K | $147.1K | $94.26 | 2.97x |
| 31624 | Irrigation and suction of lung airways to obtain cells using an endoscope | 1.5K | $125.3K | $83.01 | 4.24x |
| 71020 | X-ray of chest, 2 views, front and side | 5.8K | $115.7K | $19.84 | 2.77x |
| 94620 | Pulmonary exercise testing | 2.7K | $107.9K | $39.91 | 3.01x |
This provider submits charges 2.16 times higher than what Medicare actually pays.
A markup ratio of 2.16x means for every $100 Medicare pays, this provider initially charges $216. 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.
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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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