This provider's $4.0M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 197% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 108% in 2021
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 | $198.35 | $99.36 | 2.00x | $98.99 | $246.3K | 2.7K | 1.1K |
| 2015 | $162.67 | $82.66 | 1.97x | $80.01 | $389.5K | 4.6K | 1.2K |
| 2016 | $162.67 | $78.14 | 2.08x | $84.53 | $263.5K | 3.2K | 1.0K |
| 2017 | $157.40 | $77.83 | 2.02x | $79.57 | $251.1K | 2.9K | 849 |
| 2018 | $171.35 | $88.89 | 1.93x | $82.46 | $413.2K | 4.5K | 1.4K |
| 2019 | $177.44 | $89.96 | 1.97x | $87.48 | $252.0K | 2.7K | 803 |
| 2020 | $176.88 | $90.68 | 1.95x | $86.20 | $227.7K | 2.4K | 709 |
| 2021 | $156.49 | $71.22 | 2.20x | $85.27 | $472.5K | 6.7K | 734 |
| 2022 | $166.50 | $53.55 | 3.11x | $112.95 | $717.1K | 10.1K | 203 |
| 2023 | $166.50 | $88.88 | 1.87x | $77.62 | $730.4K | 8.8K | 228 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 27.2K | $2.0M | $74.66 | 1.80x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 11.5K | $1.1M | $98.01 | 2.03x |
| 99354 | Prolonged office or other outpatient service first hour | 2.0K | $157.7K | $79.55 | 1.85x |
| G0181 | Physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of c | 1.6K | $134.0K | $82.44 | 1.93x |
| 99327 | New patient assisted living visit, typically 60 minutes | 841 | $110.3K | $131.16 | 2.11x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 728 | $76.8K | $105.56 | 2.03x |
| 99349 | Established patient home visit, typically 40 minutes | 570 | $53.6K | $94.05 | 2.02x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 520 | $50.6K | $97.40 | 2.06x |
| 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 | 994 | $39.8K | $40.09 | 2.00x |
| 99358 | Prolonged patient service without direct patient contact first hour | 390 | $32.6K | $83.60 | 1.55x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 193 | $20.9K | $108.53 | 1.57x |
| 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 | 522 | $16.2K | $31.04 | 2.01x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 123 | $16.2K | $131.72 | 2.05x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 79 | $13.9K | $176.27 | 1.97x |
| 99356 | Prolonged inpatient or observation hospital service first hour | 180 | $13.1K | $72.66 | 2.20x |
| 99344 | New patient home visit, typically 60 minutes | 93 | $11.6K | $124.47 | 2.18x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 69 | $10.5K | $152.41 | 2.31x |
| 29581 | Application of vein wound compression system lower leg below knee including ankle and foot | 378 | $10.5K | $27.74 | 5.18x |
| 29580 | Strapping, unna boot | 200 | $6.1K | $30.73 | 4.37x |
| 97140 | Manual (physical) therapy techniques to 1 or more regions, each 15 minutes | 236 | $4.8K | $20.41 | 2.17x |
This provider submits charges 1.91 times higher than what Medicare actually pays.
A markup ratio of 1.91x means for every $100 Medicare pays, this provider initially charges $191. This is lower 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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