This provider's $10.5M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 12182% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 4940% in 2023
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 | $229.21 | $128.43 | 1.78x | $100.78 | $76.0K | 592 | 6 |
| 2015 | $204.37 | $103.53 | 1.97x | $100.84 | $83.1K | 803 | 11 |
| 2016 | $202.14 | $100.53 | 2.01x | $101.61 | $103.6K | 1.0K | 9 |
| 2017 | $194.80 | $98.26 | 1.98x | $96.54 | $146.3K | 1.5K | 14 |
| 2018 | $209.70 | $96.22 | 2.18x | $113.48 | $154.6K | 1.6K | 11 |
| 2019 | $222.78 | $102.09 | 2.18x | $120.69 | $130.5K | 1.3K | 13 |
| 2020 | $228.90 | $107.67 | 2.13x | $121.23 | $113.1K | 1.1K | 8 |
| 2021 | $200.64 | $100.38 | 2.00x | $100.26 | $147.4K | 1.5K | 18 |
| 2022 | $135.15 | $77.62 | 1.74x | $57.53 | $185.3K | 2.4K | 18 |
| 2023 | $964.79 | $745.02 | 1.29x | $219.77 | $9.3M | 12.5K | 18 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4262 | Dual layer impax membrane, per square centimeter | 3.8K | $3.8M | $987.45 | 1.28x |
| Q4281 | Barrera sl or barrera dl, per square centimeter | 2.3K | $2.7M | $1.2K | 1.28x |
| Q4191 | Restorigin, per square centimeter | 2.4K | $1.4M | $571.10 | 1.27x |
| Q4205 | Membrane graft or membrane wrap, per square centimeter | 1.0K | $1.2M | $1.2K | 1.28x |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 3.3K | $446.3K | $136.52 | 1.83x |
| 99337 | Established patient custodial care facility, group care, or assisted living visit, typically 1 hour | 1.6K | $229.3K | $144.97 | 1.72x |
| G0181 | Physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of c | 1.1K | $95.2K | $88.79 | 1.69x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 570 | $73.0K | $128.10 | 2.73x |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 1.3K | $62.9K | $50.03 | 1.50x |
| 99487 | Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month | 539 | $56.1K | $104.03 | 1.46x |
| 99345 | Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes | 349 | $54.4K | $155.86 | 1.70x |
| G0180 | Physician or allowed practitioner 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 and | 1.0K | $42.9K | $41.95 | 4.77x |
| 15271 | Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less | 300 | $38.5K | $128.43 | 2.72x |
| 99489 | Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month | 565 | $31.6K | $56.02 | 1.43x |
| 99497 | Advance care planning, first 30 minutes | 437 | $30.1K | $68.78 | 1.56x |
| 99354 | Extended office or other outpatient service, first hour | 261 | $26.7K | $102.22 | 1.47x |
| 99328 | New patient assisted living visit, typically 75 minutes | 159 | $26.3K | $165.29 | 1.66x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 266 | $25.2K | $94.92 | 2.11x |
| G0179 | Physician or allowed practitioner 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 a | 685 | $22.1K | $32.23 | 6.21x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 88 | $18.6K | $211.42 | 1.66x |
This provider submits charges 1.37 times higher than what Medicare actually pays.
A markup ratio of 1.37x means for every $100 Medicare pays, this provider initially charges $137. 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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