This provider's $4.9M in total Medicare payments ranks in the 99th percentile of Infectious Disease providers nationally.
Medicare payments to this provider grew 81% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 52% in 2015
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 | $212.79 | $100.77 | 2.11x | $112.02 | $303.5K | 3.6K | 1.8K |
| 2015 | $191.92 | $86.66 | 2.21x | $105.26 | $459.8K | 6.5K | 2.3K |
| 2016 | $185.69 | $84.50 | 2.20x | $101.19 | $440.5K | 6.1K | 2.2K |
| 2017 | $216.06 | $95.55 | 2.26x | $120.51 | $442.7K | 4.9K | 2.2K |
| 2018 | $212.36 | $95.51 | 2.22x | $116.85 | $479.9K | 5.2K | 2.3K |
| 2019 | $218.04 | $101.86 | 2.14x | $116.18 | $488.4K | 5.4K | 2.5K |
| 2020 | $205.92 | $93.84 | 2.19x | $112.08 | $467.5K | 5.3K | 2.4K |
| 2021 | $207.80 | $100.47 | 2.07x | $107.33 | $699.9K | 8.4K | 3.4K |
| 2022 | $183.00 | $84.06 | 2.18x | $98.94 | $591.7K | 7.6K | 3.2K |
| 2023 | $202.89 | $98.86 | 2.05x | $104.03 | $549.6K | 6.1K | 2.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 24.6K | $2.1M | $84.49 | 2.60x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 4.2K | $681.4K | $160.48 | 1.68x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.9K | $558.4K | $80.86 | 1.83x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 9.0K | $523.5K | $58.36 | 2.55x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 3.7K | $393.6K | $105.05 | 2.57x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 1.9K | $123.9K | $66.13 | 2.57x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 627 | $99.1K | $158.03 | 2.06x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 1.8K | $96.7K | $52.81 | 2.56x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 813 | $91.7K | $112.81 | 2.10x |
| 36590 | Removal of peripheral venous catheter for infusion | 372 | $69.6K | $187.05 | 1.87x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.1K | $60.8K | $54.23 | 1.89x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 331 | $41.0K | $123.86 | 2.23x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 897 | $28.8K | $32.06 | 3.12x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 298 | $14.8K | $49.68 | 2.62x |
| 96366 | Infusion into a vein for therapy, prevention, or diagnosis | 892 | $12.9K | $14.46 | 2.56x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 84 | $10.8K | $128.48 | 2.44x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 102 | $9.7K | $94.96 | 2.90x |
| 11042 | Removal of skin and tissue first 20 sq cm or less | 182 | $8.7K | $47.91 | 3.84x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 71 | $7.2K | $100.83 | 2.50x |
| 36569 | Insertion of central venous catheter for infusion, patient 5 years or older | 31 | $5.9K | $191.52 | 2.76x |
This provider submits charges 2.34 times higher than what Medicare actually pays.
A markup ratio of 2.34x means for every $100 Medicare pays, this provider initially charges $234. 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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