This provider's $3.4M in total Medicare payments ranks in the 99th percentile of Hospitalist providers nationally.
Medicare payments to this provider grew 1052% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 192% in 2016
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 | $321.12 | $90.62 | 3.54x | $230.50 | $62.1K | 712 | 510 |
| 2015 | $298.08 | $87.61 | 3.40x | $210.47 | $46.3K | 561 | 366 |
| 2016 | $469.87 | $102.80 | 4.57x | $367.07 | $135.2K | 1.5K | 661 |
| 2017 | $519.51 | $104.72 | 4.96x | $414.79 | $197.6K | 2.0K | 912 |
| 2018 | $582.84 | $111.66 | 5.22x | $471.18 | $143.1K | 1.5K | 667 |
| 2019 | $580.01 | $119.62 | 4.85x | $460.39 | $238.6K | 2.4K | 1.0K |
| 2020 | $579.02 | $117.04 | 4.95x | $461.98 | $376.0K | 3.6K | 1.7K |
| 2021 | $546.92 | $114.74 | 4.77x | $432.18 | $731.9K | 7.2K | 3.2K |
| 2022 | $611.18 | $112.28 | 5.44x | $498.90 | $717.7K | 7.7K | 2.7K |
| 2023 | $590.81 | $105.20 | 5.62x | $485.61 | $715.2K | 7.2K | 3.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 15.9K | $1.4M | $89.11 | 3.57x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 3.7K | $589.5K | $161.29 | 5.02x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 6.7K | $514.4K | $76.47 | 7.97x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 1.3K | $232.0K | $182.81 | 4.45x |
| 99239 | Hospital discharge day management, more than 30 minutes | 2.2K | $200.9K | $91.53 | 4.59x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 1.3K | $172.5K | $137.35 | 4.36x |
| 99497 | Advance care planning by the physician or other qualified health care professional, first 30 minutes | 1.5K | $97.3K | $64.90 | 3.97x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 783 | $47.4K | $60.56 | 3.93x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 297 | $32.0K | $107.58 | 5.49x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 487 | $28.9K | $59.27 | 9.37x |
| 99483 | Assessment of and care planning for patient with impaired thought processing, typically 60 minutes | 51 | $8.3K | $162.93 | 3.68x |
| 99238 | Hospital discharge day management, 30 minutes or less | 86 | $5.6K | $65.03 | 5.14x |
| 99236 | Hospital observation or inpatient care admitted and discharged on the same day for high severity problem, typically 55 minutes | 28 | $5.0K | $178.13 | 5.04x |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | 38 | $4.3K | $112.09 | 6.16x |
| 99220 | Hospital observation care typically 70 minutes per day | 27 | $3.9K | $142.88 | 5.81x |
| 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 | 87 | $3.8K | $43.22 | 3.23x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 13 | $2.2K | $169.53 | 5.01x |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 20 | $2.2K | $107.52 | 8.34x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 17 | $536.86 | $31.58 | 3.62x |
This provider submits charges 4.76 times higher than what Medicare actually pays.
A markup ratio of 4.76x means for every $100 Medicare pays, this provider initially charges $476. 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.
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data