This provider's $5.0M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 324% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 302% in 2019
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 | $157.99 | $82.33 | 1.92x | $75.66 | $283.3K | 3.9K | 1.0K |
| 2015 | $137.70 | $74.72 | 1.84x | $62.98 | $439.5K | 6.1K | 1.3K |
| 2016 | $173.54 | $88.27 | 1.97x | $85.27 | $399.3K | 5.6K | 1.1K |
| 2017 | $178.92 | $96.88 | 1.85x | $82.04 | $392.3K | 5.5K | 1.0K |
| 2018 | $186.13 | $91.06 | 2.04x | $95.07 | $82.1K | 1.2K | 356 |
| 2019 | $157.91 | $77.25 | 2.04x | $80.66 | $330.5K | 4.7K | 1.4K |
| 2020 | $174.38 | $81.49 | 2.14x | $92.89 | $641.7K | 8.3K | 2.6K |
| 2021 | $158.33 | $77.77 | 2.04x | $80.56 | $481.9K | 6.7K | 2.1K |
| 2022 | $152.16 | $78.52 | 1.94x | $73.64 | $746.2K | 10.4K | 3.8K |
| 2023 | $166.18 | $91.78 | 1.81x | $74.40 | $1.2M | 15.9K | 4.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 23.4K | $1.9M | $83.20 | 1.97x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 30.3K | $1.9M | $61.83 | 2.06x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 2.4K | $364.5K | $151.08 | 1.65x |
| 99349 | Established patient home visit, typically 40 minutes | 1.9K | $195.0K | $103.08 | 1.93x |
| 99316 | Nursing facility discharge management, more than 30 minutes | 1.5K | $149.9K | $97.36 | 2.00x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 3.6K | $135.2K | $37.41 | 2.64x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 1.6K | $116.9K | $75.18 | 2.00x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 2.0K | $98.5K | $49.24 | 2.86x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 270 | $32.1K | $118.87 | 1.62x |
| G0179 | Physician re-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 im | 636 | $23.9K | $37.59 | 1.82x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 107 | $17.9K | $166.85 | 1.50x |
| 99345 | New patient home visit, typically 75 minutes | 64 | $10.0K | $156.90 | 1.77x |
| 99350 | Established patient home visit, typically 60 minutes | 55 | $9.0K | $162.93 | 1.83x |
| 99315 | Nursing facility discharge day management, 30 minutes or less | 98 | $6.7K | $68.56 | 1.96x |
| 99305 | Initial nursing facility visit per day, typically 35 minutes | 32 | $3.7K | $114.94 | 1.74x |
| 43762 | Replacement of stomach stoma tube accessed through skin | 16 | $3.5K | $217.76 | 2.35x |
| 99328 | New patient assisted living visit, typically 75 minutes | 17 | $3.2K | $188.06 | 1.33x |
| 69210 | Removal of impact ear wax, one ear | 42 | $1.9K | $45.76 | 1.74x |
| 99348 | Established patient home visit, typically 25 minutes | 25 | $1.8K | $73.50 | 2.04x |
| 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 | 36 | $1.7K | $48.08 | 2.69x |
This provider submits charges 2.01 times higher than what Medicare actually pays.
A markup ratio of 2.01x means for every $100 Medicare pays, this provider initially charges $201. 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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