This provider's $12.7M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 7754% from 2014 to 2023.
87% of their billing comes from a single procedure code (Q4253 — Zenith amniotic membrane, per square centimeter).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 5724% 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 | $208.69 | $74.41 | 2.80x | $134.28 | $144.7K | 1.9K | 6 |
| 2015 | $211.70 | $78.24 | 2.71x | $133.46 | $179.8K | 2.3K | 9 |
| 2016 | $310.47 | $76.18 | 4.08x | $234.29 | $89.5K | 1.2K | 7 |
| 2017 | $628.16 | $86.01 | 7.30x | $542.15 | $91.4K | 1.1K | 7 |
| 2018 | $583.19 | $93.16 | 6.26x | $490.03 | $172.9K | 1.9K | 13 |
| 2019 | $694.79 | $89.11 | 7.80x | $605.68 | $151.3K | 1.7K | 9 |
| 2020 | $865.02 | $100.21 | 8.63x | $764.81 | $153.5K | 1.5K | 7 |
| 2021 | $880.91 | $98.54 | 8.94x | $782.37 | $173.8K | 1.8K | 7 |
| 2022 | $390.09 | $84.20 | 4.63x | $305.89 | $195.2K | 2.3K | 8 |
| 2023 | $567.40 | $433.83 | 1.31x | $133.57 | $11.4M | 26.2K | 8 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4253 | Zenith amniotic membrane, per square centimeter | 22.9K | $11.0M | $482.00 | 1.28x |
| 99233 | Follow-up hospital inpatient care per day, typically 35 minutes | 6.7K | $557.3K | $83.34 | 6.23x |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 2.8K | $318.7K | $113.68 | 5.28x |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 2.4K | $183.7K | $76.96 | 3.42x |
| 99232 | Follow-up hospital inpatient care per day, typically 25 minutes | 3.0K | $174.3K | $57.91 | 5.28x |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 1.0K | $143.8K | $137.20 | 2.79x |
| 99223 | Initial hospital inpatient care per day, typically 70 minutes | 511 | $84.3K | $164.92 | 6.96x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 461 | $83.2K | $180.50 | 7.93x |
| 99497 | Advance care planning, first 30 minutes | 1.1K | $63.5K | $60.28 | 2.67x |
| 99356 | Extended inpatient or observation hospital service, first hour | 324 | $23.1K | $71.33 | 2.68x |
| 99239 | Hospital discharge day management, more than 30 minutes | 230 | $19.7K | $85.56 | 4.76x |
| 99316 | Nursing facility discharge management, more than 30 minutes | 104 | $9.9K | $94.99 | 3.34x |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | 86 | $8.8K | $102.71 | 2.69x |
| 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 | 40 | $5.0K | $125.08 | 1.32x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 43 | $4.7K | $109.23 | 2.66x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 64 | $2.0K | $31.01 | 2.89x |
| 15272 | Application of skin substitute graft to wound of trunk, arms, or legs, each additional 25.0 sq cm of wound 100.0 sq cm or less | 80 | $1.6K | $19.42 | 1.34x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 28 | $1.5K | $54.66 | 2.58x |
This provider submits charges 1.8 times higher than what Medicare actually pays.
A markup ratio of 1.8x means for every $100 Medicare pays, this provider initially charges $180. 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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