This provider's $4.8M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 96% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 115% in 2022
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 | $166.34 | $75.64 | 2.20x | $90.70 | $469.8K | 6.6K | 2.6K |
| 2015 | $169.16 | $72.02 | 2.35x | $97.14 | $390.7K | 5.2K | 2.3K |
| 2016 | $174.67 | $76.39 | 2.29x | $98.28 | $398.9K | 5.6K | 2.3K |
| 2017 | $144.67 | $66.36 | 2.18x | $78.31 | $405.7K | 6.5K | 3.1K |
| 2018 | $140.07 | $66.85 | 2.10x | $73.22 | $440.8K | 7.1K | 2.9K |
| 2019 | $107.18 | $48.32 | 2.22x | $58.86 | $332.2K | 4.9K | 1.7K |
| 2020 | $121.17 | $50.09 | 2.42x | $71.08 | $280.2K | 5.2K | 1.6K |
| 2021 | $134.79 | $63.51 | 2.12x | $71.28 | $369.7K | 5.1K | 1.4K |
| 2022 | $135.93 | $67.04 | 2.03x | $68.89 | $793.1K | 8.4K | 1.7K |
| 2023 | $127.12 | $61.65 | 2.06x | $65.47 | $919.9K | 8.5K | 1.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 17.1K | $1.8M | $106.44 | 1.89x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 23.9K | $1.8M | $74.55 | 2.06x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 2.2K | $288.9K | $128.56 | 1.98x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.6K | $204.1K | $79.91 | 2.33x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.3K | $107.8K | $47.88 | 2.25x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 3.3K | $94.8K | $29.00 | 1.55x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 1.3K | $74.2K | $57.41 | 3.48x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 443 | $68.0K | $153.58 | 2.12x |
| 93922 | Ultrasound study of arteries of both arms and legs | 842 | $54.9K | $65.17 | 1.98x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 477 | $49.8K | $104.31 | 2.26x |
| 99239 | Hospital discharge day management, more than 30 minutes | 569 | $46.7K | $82.14 | 2.33x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 2.8K | $32.6K | $11.86 | 2.19x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 168 | $29.2K | $173.85 | 1.94x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 1.6K | $23.8K | $14.57 | 1.87x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 163 | $20.0K | $123.00 | 1.55x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 89 | $14.7K | $164.86 | 1.64x |
| 99220 | Hospital observation care typically 70 minutes per day | 97 | $13.8K | $141.84 | 2.23x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 239 | $13.4K | $55.89 | 2.25x |
| 99315 | Nursing facility discharge day management, 30 minutes or less | 193 | $11.4K | $59.31 | 4.24x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 627 | $8.7K | $13.91 | 2.70x |
This provider submits charges 2.03 times higher than what Medicare actually pays.
A markup ratio of 2.03x means for every $100 Medicare pays, this provider initially charges $203. 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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