This provider's $5.2M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $504.70 | $127.76 | 3.95x | $376.94 | $709.1K | 8.9K | 1.8K |
| 2015 | $510.66 | $122.86 | 4.16x | $387.80 | $550.6K | 7.7K | 1.5K |
| 2016 | $461.46 | $115.44 | 4.00x | $346.02 | $428.4K | 6.3K | 1.1K |
| 2017 | $344.71 | $93.06 | 3.70x | $251.65 | $428.1K | 6.4K | 1.4K |
| 2018 | $364.13 | $99.71 | 3.65x | $264.42 | $412.0K | 5.8K | 1.7K |
| 2019 | $545.76 | $127.19 | 4.29x | $418.57 | $590.0K | 7.7K | 1.4K |
| 2020 | $589.22 | $143.43 | 4.11x | $445.79 | $578.1K | 7.5K | 1.2K |
| 2021 | $552.00 | $152.77 | 3.61x | $399.23 | $534.1K | 6.8K | 1.3K |
| 2022 | $588.28 | $158.97 | 3.70x | $429.31 | $481.0K | 6.2K | 1.2K |
| 2023 | $599.25 | $156.43 | 3.83x | $442.82 | $528.6K | 6.8K | 957 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 42.2K | $2.6M | $60.46 | 3.49x |
| 90935 | Hemodialysis procedure with one physician evaluation | 16.7K | $1.0M | $60.32 | 10.41x |
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 2.2K | $549.4K | $246.79 | 3.61x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 1.6K | $328.8K | $209.30 | 3.76x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 2.6K | $290.4K | $110.92 | 3.58x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 937 | $156.5K | $167.05 | 3.04x |
| 90966 | Home dialysis services per month, patient 20 years of age or older | 504 | $113.3K | $224.76 | 3.84x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 725 | $62.2K | $85.79 | 2.56x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 381 | $59.3K | $155.60 | 3.60x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.0K | $55.8K | $55.53 | 2.86x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 428 | $37.1K | $86.65 | 4.89x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 85 | $10.8K | $127.21 | 2.92x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 83 | $6.6K | $79.21 | 2.89x |
| 90945 | Dialysis procedure including one evaluation | 48 | $3.5K | $73.27 | 2.96x |
| 80048 | Blood test, basic group of blood chemicals | 301 | $3.2K | $10.76 | 4.09x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 36 | $3.1K | $87.10 | 2.82x |
| 36415 | Insertion of needle into vein for collection of blood sample | 301 | $884.94 | $2.94 | 6.80x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 21 | $692.02 | $32.95 | 2.52x |
This provider submits charges 4.84 times higher than what Medicare actually pays.
A markup ratio of 4.84x means for every $100 Medicare pays, this provider initially charges $484. 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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