This provider averages 52 services per working day
Based on 129.9K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $6.4M in total Medicare payments ranks in the 99th percentile of Emergency Medicine providers nationally.
Averaging 52 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 161% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
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 | $75.96 | $22.14 | 3.43x | $53.82 | $355.7K | 9.7K | 5.1K |
| 2015 | $113.84 | $33.56 | 3.39x | $80.28 | $417.3K | 10.4K | 5.7K |
| 2016 | $109.15 | $29.37 | 3.72x | $79.78 | $335.4K | 8.7K | 5.1K |
| 2017 | $113.24 | $32.77 | 3.46x | $80.47 | $444.4K | 12.2K | 5.4K |
| 2018 | $125.46 | $35.68 | 3.52x | $89.78 | $491.3K | 13.5K | 6.0K |
| 2019 | $128.01 | $36.13 | 3.54x | $91.88 | $608.7K | 13.9K | 6.7K |
| 2020 | $111.05 | $38.00 | 2.92x | $73.05 | $884.6K | 15.5K | 6.4K |
| 2021 | $109.05 | $40.20 | 2.71x | $68.85 | $830.3K | 13.4K | 6.3K |
| 2022 | $112.68 | $39.13 | 2.88x | $73.55 | $1.1M | 17.3K | 7.0K |
| 2023 | $115.05 | $39.61 | 2.90x | $75.44 | $927.1K | 15.4K | 6.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 39.3K | $3.5M | $88.70 | 2.90x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 29.9K | $997.9K | $33.37 | 3.09x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.9K | $470.7K | $59.75 | 2.91x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 1.6K | $186.7K | $116.75 | 2.33x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 671 | $128.5K | $191.55 | 2.90x |
| 94060 | Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration | 3.1K | $119.2K | $38.21 | 3.69x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.3K | $91.1K | $69.15 | 3.71x |
| 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 | 2.8K | $85.8K | $30.41 | 3.19x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 6.1K | $85.6K | $14.02 | 4.20x |
| 77080 | Bone density measurement using dedicated X-ray machine | 2.0K | $76.6K | $38.45 | 3.03x |
| 99483 | Assessment of and care planning for patient with impaired thought processing, typically 60 minutes | 233 | $47.4K | $203.52 | 2.32x |
| 87426 | Coronavirus ag ia | 1.1K | $44.5K | $41.64 | 2.74x |
| 93922 | Ultrasound study of arteries of both arms and legs, limited | 715 | $42.3K | $59.16 | 3.48x |
| 87635 | Sars-cov-2 covid-19 amp prb | 770 | $39.3K | $50.98 | 2.51x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 915 | $39.1K | $42.69 | 4.08x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 297 | $35.3K | $118.87 | 4.49x |
| 90674 | Vaccine for influenza for administration into muscle, 0.5 ml dosage | 993 | $27.9K | $28.13 | 2.03x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 2.1K | $23.2K | $11.10 | 3.60x |
| G0008 | Administration of influenza virus vaccine | 1.7K | $18.9K | $11.05 | 1.29x |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 113 | $18.2K | $160.76 | 2.39x |
This provider submits charges 3 times higher than what Medicare actually pays.
A markup ratio of 3x means for every $100 Medicare pays, this provider initially charges $300. 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.
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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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