This provider's $4.5M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 8907% from 2014 to 2023.
91% of their billing comes from a single procedure code (90960 — Dialysis services (4 or more physician visits per month), patient 20 years of age and older).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 2724% in 2019
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 | $219.92 | $53.43 | 4.12x | $166.49 | $10.3K | 241 | 109 |
| 2015 | $194.86 | $45.06 | 4.32x | $149.80 | $11.1K | 239 | 142 |
| 2016 | $193.98 | $43.89 | 4.42x | $150.09 | $15.9K | 344 | 185 |
| 2017 | $194.23 | $43.01 | 4.52x | $151.22 | $13.9K | 310 | 145 |
| 2018 | $197.66 | $45.33 | 4.36x | $152.33 | $4.2K | 108 | 72 |
| 2019 | $187.68 | $129.56 | 1.45x | $58.12 | $118.8K | 634 | 557 |
| 2020 | $197.57 | $141.11 | 1.40x | $56.46 | $1.3M | 5.6K | 896 |
| 2021 | $206.91 | $146.43 | 1.41x | $60.48 | $1.1M | 4.4K | 911 |
| 2022 | $225.88 | $162.34 | 1.39x | $63.54 | $1.0M | 3.7K | 866 |
| 2023 | $187.35 | $137.19 | 1.37x | $50.16 | $927.8K | 3.6K | 889 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90960 | Dialysis services (4 or more physician visits per month), patient 20 years of age and older | 15.6K | $4.1M | $260.79 | 1.32x |
| 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 1.1K | $239.3K | $222.02 | 1.32x |
| 90966 | Home dialysis services per month, patient 20 years of age or older | 275 | $52.9K | $192.42 | 1.44x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 651 | $34.1K | $52.31 | 2.04x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 270 | $21.3K | $79.02 | 4.28x |
| 90962 | Dialysis services (1 physician visit per month), patient 20 years of age and older | 122 | $18.7K | $153.14 | 1.37x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 559 | $17.2K | $30.85 | 4.33x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 123 | $11.1K | $90.62 | 1.41x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 182 | $10.2K | $56.15 | 4.26x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 67 | $9.8K | $146.14 | 1.53x |
| 36593 | Declotting infusion of implanted central venous access device or catheter | 166 | $4.8K | $29.11 | 1.27x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 40 | $4.4K | $109.06 | 1.63x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 103 | $1.7K | $16.30 | 5.34x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 12 | $1.1K | $91.39 | 1.70x |
This provider submits charges 1.36 times higher than what Medicare actually pays.
A markup ratio of 1.36x means for every $100 Medicare pays, this provider initially charges $136. 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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