This provider's $4.8M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 237% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 80% in 2018
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 | $91.03 | $41.65 | 2.19x | $49.38 | $217.7K | 5.1K | 2.1K |
| 2015 | $121.85 | $55.24 | 2.21x | $66.61 | $212.5K | 4.6K | 1.8K |
| 2016 | $123.28 | $58.61 | 2.10x | $64.67 | $225.6K | 4.7K | 2.0K |
| 2017 | $106.28 | $53.37 | 1.99x | $52.91 | $236.2K | 5.0K | 2.5K |
| 2018 | $85.16 | $43.98 | 1.94x | $41.18 | $424.2K | 9.8K | 3.8K |
| 2019 | $86.43 | $46.96 | 1.84x | $39.47 | $607.3K | 13.1K | 6.0K |
| 2020 | $105.16 | $57.77 | 1.82x | $47.39 | $657.4K | 14.0K | 4.8K |
| 2021 | $96.06 | $50.34 | 1.91x | $45.72 | $707.0K | 14.2K | 4.1K |
| 2022 | $108.77 | $61.12 | 1.78x | $47.65 | $818.1K | 14.0K | 4.2K |
| 2023 | $107.77 | $57.71 | 1.87x | $50.06 | $734.5K | 12.5K | 3.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 24.2K | $1.5M | $61.65 | 1.80x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 32.9K | $1.4M | $42.95 | 2.10x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.6K | $465.1K | $101.26 | 1.66x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 1.4K | $181.8K | $134.19 | 1.19x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 2.0K | $170.2K | $87.04 | 1.15x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 2.8K | $153.6K | $54.27 | 1.66x |
| 99457 | Remote monitoring of physiologic parameters management services, 20 minutes or more of qualified health care professional time per calendar month | 3.5K | $152.4K | $44.06 | 1.82x |
| 93922 | Ultrasound study of arteries of both arms and legs | 1.0K | $77.7K | $74.96 | 4.67x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 391 | $70.7K | $180.69 | 1.11x |
| G0446 | Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes | 1.8K | $49.2K | $28.07 | 2.14x |
| G0108 | Diabetes outpatient self-management training services, individual, per 30 minutes | 1.1K | $45.7K | $42.35 | 4.02x |
| G0008 | Administration of influenza virus vaccine | 1.6K | $40.4K | $24.51 | 1.24x |
| G0442 | Annual alcohol misuse screening, 15 minutes | 1.9K | $38.1K | $20.34 | 1.97x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 445 | $35.5K | $79.84 | 1.72x |
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 1.4K | $33.9K | $24.20 | 1.59x |
| G0506 | Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) | 613 | $30.4K | $49.54 | 2.02x |
| G0444 | Annual depression screening, 15 minutes | 1.4K | $28.5K | $20.40 | 1.96x |
| 36410 | Insertion of needle into vein, patient 3 years or older | 1.9K | $27.3K | $14.24 | 2.11x |
| 97124 | Therapeutic massage to 1 or more areas, each 15 minutes | 1.4K | $26.0K | $18.59 | 2.48x |
| 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 | 557 | $25.7K | $46.12 | 1.99x |
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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