This provider's $3.5M in total Medicare payments ranks in the 99th percentile of Neurology providers nationally.
Their average markup ratio of 5.45x is significantly above the specialty median of 3.5x.
Medicare payments to this provider grew 354% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 97% 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 | $216.46 | $78.50 | 2.76x | $137.96 | $160.1K | 2.4K | 1.6K |
| 2015 | $470.92 | $92.34 | 5.10x | $378.58 | $228.0K | 2.3K | 1.8K |
| 2016 | $509.73 | $83.76 | 6.09x | $425.97 | $295.7K | 3.6K | 2.5K |
| 2017 | $547.09 | $81.98 | 6.67x | $465.11 | $280.9K | 3.7K | 2.4K |
| 2018 | $581.97 | $89.03 | 6.54x | $492.94 | $337.1K | 4.5K | 2.5K |
| 2019 | $484.64 | $94.28 | 5.14x | $390.36 | $382.8K | 5.0K | 2.9K |
| 2020 | $459.87 | $90.37 | 5.09x | $369.50 | $235.4K | 2.8K | 1.9K |
| 2021 | $542.10 | $107.05 | 5.06x | $435.05 | $303.0K | 3.1K | 2.2K |
| 2022 | $1.2K | $215.43 | 5.77x | $1.0K | $596.5K | 5.6K | 3.2K |
| 2023 | $581.01 | $103.21 | 5.63x | $477.80 | $726.9K | 7.7K | 4.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 12.5K | $1.1M | $91.45 | 5.31x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 2.5K | $423.3K | $168.36 | 5.30x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 2.1K | $348.8K | $162.55 | 4.88x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 4.4K | $270.8K | $61.00 | 4.87x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.6K | $204.1K | $124.42 | 5.27x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 4.6K | $148.5K | $32.50 | 4.94x |
| 95816 | Measurement and recording of brain wave (EEG) activity, awake and drowsy | 2.6K | $121.4K | $47.21 | 10.79x |
| 95886 | Needle measurement and recording of electrical activity of muscles of arm or leg complete study | 1.2K | $102.7K | $87.21 | 4.68x |
| 95819 | Measurement and recording of brain wave (EEG) activity, awake and asleep | 611 | $81.5K | $133.38 | 5.53x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 567 | $62.9K | $110.89 | 5.10x |
| 64615 | Injection of chemical for destruction of facial and neck nerve muscles on both sides of face | 444 | $58.1K | $130.90 | 5.19x |
| 99220 | Hospital observation care typically 70 minutes per day | 371 | $56.1K | $151.15 | 5.20x |
| 33285 | Insertion of heart rhythm monitor under skin | 13 | $49.7K | $3.8K | 5.58x |
| 95910 | Nerve transmission studies, 7-8 studies | 302 | $45.7K | $151.47 | 5.12x |
| 64616 | Injection of chemical for destruction of nerve muscles on one side of neck excluding voice box accessed through the skin | 230 | $32.9K | $143.05 | 5.83x |
| 95909 | Nerve transmission studies, 5-6 studies | 284 | $32.1K | $113.00 | 5.37x |
| 95908 | Nerve transmission studies, 3-4 studies | 304 | $29.8K | $97.88 | 5.25x |
| 95953 | Monitoring and localization of seizure activity over 24-hour period using portable 16-channel electroencephalograph (EEG) | 212 | $28.2K | $132.81 | 9.65x |
| 64400 | Injection of anesthetic agent, trigeminal nerve | 275 | $26.4K | $96.08 | 5.15x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 396 | $26.2K | $66.24 | 4.66x |
This provider submits charges 5.45 times higher than what Medicare actually pays.
A markup ratio of 5.45x means for every $100 Medicare pays, this provider initially charges $545. 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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