This provider's $3.9M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $79.47 | $38.20 | 2.08x | $41.27 | $325.0K | 9.8K | 1.7K |
| 2015 | $77.82 | $37.33 | 2.08x | $40.49 | $277.2K | 8.7K | 1.7K |
| 2016 | $83.77 | $40.65 | 2.06x | $43.12 | $288.1K | 7.1K | 1.6K |
| 2017 | $67.22 | $33.97 | 1.98x | $33.25 | $281.4K | 7.9K | 1.5K |
| 2018 | $78.38 | $38.97 | 2.01x | $39.41 | $345.8K | 9.1K | 1.7K |
| 2019 | $85.30 | $38.34 | 2.22x | $46.96 | $429.8K | 10.6K | 2.1K |
| 2020 | $75.91 | $34.92 | 2.17x | $40.99 | $405.3K | 10.2K | 2.0K |
| 2021 | $108.21 | $47.10 | 2.30x | $61.11 | $521.6K | 12.7K | 2.0K |
| 2022 | $107.18 | $45.08 | 2.38x | $62.10 | $540.3K | 13.5K | 2.1K |
| 2023 | $119.78 | $47.40 | 2.53x | $72.38 | $487.1K | 12.6K | 1.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 23.9K | $1.3M | $55.25 | 2.31x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 8.7K | $779.2K | $89.49 | 2.18x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 9.2K | $528.1K | $57.23 | 2.38x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.2K | $177.4K | $82.00 | 2.27x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 1.6K | $172.5K | $106.05 | 2.28x |
| J1335 | Injection, ertapenem sodium, 500 mg | 6.1K | $169.5K | $27.90 | 2.06x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 6.1K | $149.1K | $24.47 | 2.32x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 863 | $136.2K | $157.81 | 2.27x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 685 | $86.5K | $126.35 | 2.34x |
| 97597 | Removal of tissue from wounds per session | 794 | $59.0K | $74.28 | 2.23x |
| 96366 | Infusion into a vein for therapy, prevention, or diagnosis | 2.3K | $38.5K | $16.43 | 2.24x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 578 | $34.2K | $59.12 | 2.12x |
| 96375 | Injection of different drug or substance into a vein for therapy, diagnosis, or prevention | 2.1K | $30.2K | $14.47 | 2.26x |
| J1561 | Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg | 759 | $25.4K | $33.47 | 1.68x |
| 36415 | Insertion of needle into vein for collection of blood sample | 6.0K | $22.2K | $3.67 | 2.83x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 475 | $18.5K | $38.88 | 2.06x |
| 36573 | Insertion of central venous catheter for infusion using imaging guidance, patient 5 years or older | 56 | $18.2K | $324.26 | 1.98x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 156 | $16.9K | $108.65 | 2.05x |
| 96368 | Infusion into a vein for therapy, prevention, or diagnosis, concurrent with another infusion | 986 | $16.1K | $16.33 | 2.17x |
| 96360 | Hydration infusion into a vein 31 minutes to 1 hour | 451 | $12.9K | $28.52 | 2.81x |
This provider submits charges 2.29 times higher than what Medicare actually pays.
A markup ratio of 2.29x means for every $100 Medicare pays, this provider initially charges $229. 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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