This provider's $8.2M 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 | $280.85 | $93.27 | 3.01x | $187.58 | $848.4K | 11.4K | 2.6K |
| 2015 | $273.39 | $95.30 | 2.87x | $178.09 | $844.8K | 11.9K | 2.9K |
| 2016 | $273.72 | $95.34 | 2.87x | $178.38 | $871.8K | 12.3K | 3.1K |
| 2017 | $273.92 | $93.35 | 2.93x | $180.57 | $850.9K | 12.3K | 2.8K |
| 2018 | $273.83 | $96.49 | 2.84x | $177.34 | $775.1K | 11.8K | 2.3K |
| 2019 | $250.29 | $89.83 | 2.79x | $160.46 | $778.3K | 12.0K | 2.0K |
| 2020 | $241.80 | $87.13 | 2.78x | $154.67 | $795.3K | 12.3K | 1.7K |
| 2021 | $241.77 | $91.55 | 2.64x | $150.22 | $748.4K | 11.0K | 1.8K |
| 2022 | $227.26 | $83.49 | 2.72x | $143.77 | $838.3K | 12.5K | 2.1K |
| 2023 | $209.70 | $83.06 | 2.52x | $126.64 | $813.3K | 11.2K | 2.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 61.8K | $3.3M | $53.85 | 2.84x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 31.4K | $2.3M | $72.13 | 2.81x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 10.2K | $1.1M | $104.73 | 2.86x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 4.9K | $636.2K | $129.20 | 2.80x |
| 99316 | Nursing facility discharge management, more than 30 minutes | 3.5K | $296.0K | $83.74 | 2.28x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.7K | $216.8K | $81.72 | 2.85x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 485 | $77.4K | $159.56 | 2.78x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.3K | $75.8K | $56.26 | 2.90x |
| 99239 | Hospital discharge day management, more than 30 minutes | 796 | $67.1K | $84.31 | 2.88x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 199 | $35.2K | $177.04 | 3.63x |
| 99220 | Hospital observation care typically 70 minutes per day | 204 | $29.6K | $145.05 | 2.60x |
| 99225 | Subsequent observation care, typically 25 minutes per day | 325 | $18.4K | $56.71 | 2.49x |
| 99217 | Hospital observation care discharge | 282 | $15.8K | $56.11 | 3.01x |
| 99307 | Follow-up nursing facility visit per day, typically 10 minutes | 430 | $13.0K | $30.26 | 3.30x |
| 99305 | Initial nursing facility visit per day, typically 35 minutes | 97 | $9.8K | $101.51 | 2.78x |
| 99226 | Subsequent observation care, typically 35 minutes per day | 108 | $8.9K | $82.27 | 2.55x |
| 36556 | Insertion of central venous catheter for infusion, patient 5 years or older | 32 | $3.2K | $100.65 | 5.69x |
| G0180 | Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple | 29 | $1.1K | $38.65 | 2.82x |
| 99407 | Smoking and tobacco use intensive counseling, more than 10 minutes | 18 | $492.48 | $27.36 | 3.18x |
This provider submits charges 2.82 times higher than what Medicare actually pays.
A markup ratio of 2.82x means for every $100 Medicare pays, this provider initially charges $282. 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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