This provider's $9.4M in total Medicare payments ranks in the 99th percentile of Critical Care (Intensivists) 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 | $241.84 | $62.42 | 3.87x | $179.42 | $1.1M | 15.4K | 6.0K |
| 2015 | $241.52 | $66.39 | 3.64x | $175.13 | $1.0M | 13.4K | 5.8K |
| 2016 | $229.42 | $65.04 | 3.53x | $164.38 | $990.7K | 12.7K | 6.1K |
| 2017 | $225.18 | $60.95 | 3.69x | $164.23 | $871.4K | 12.4K | 5.9K |
| 2018 | $207.69 | $59.90 | 3.47x | $147.79 | $996.6K | 12.8K | 6.1K |
| 2019 | $170.09 | $56.24 | 3.02x | $113.85 | $802.3K | 10.6K | 5.4K |
| 2020 | $178.63 | $65.43 | 2.73x | $113.20 | $776.7K | 8.8K | 4.2K |
| 2021 | $187.82 | $67.55 | 2.78x | $120.27 | $878.6K | 9.0K | 3.8K |
| 2022 | $160.98 | $70.67 | 2.28x | $90.31 | $954.1K | 9.1K | 3.4K |
| 2023 | $156.93 | $67.91 | 2.31x | $89.02 | $1.0M | 10.3K | 3.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 14.6K | $2.7M | $188.32 | 2.66x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 17.1K | $1.5M | $90.00 | 2.22x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 8.2K | $1.1M | $134.72 | 1.86x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 8.8K | $606.6K | $69.01 | 2.04x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.6K | $522.5K | $94.01 | 2.03x |
| 94060 | Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration | 9.0K | $472.9K | $52.50 | 2.85x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.7K | $291.7K | $167.23 | 2.39x |
| 94660 | Initiation and management of continued pressured respiratory assistance by mask or breathing tube | 5.1K | $280.2K | $54.83 | 2.74x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 3.4K | $208.4K | $61.27 | 2.45x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 1.5K | $180.0K | $122.10 | 1.31x |
| 99292 | Critical care delivery critically ill or injured patient | 1.5K | $143.7K | $94.89 | 2.64x |
| 94750 | Measurement of lung stretching capacity | 1.7K | $125.0K | $71.63 | 2.06x |
| G0399 | Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation | 793 | $118.1K | $148.89 | 3.36x |
| 94729 | Measurement of lung diffusing capacity | 2.2K | $110.8K | $49.69 | 3.59x |
| 94726 | Determination of lung volumes using plethysmography | 2.2K | $106.1K | $47.37 | 2.38x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 1.2K | $101.5K | $83.24 | 2.39x |
| 94640 | Respiratory inhaled pressure or nonpressure treatment to relieve airway obstruction or for sputum specimen | 4.2K | $64.9K | $15.54 | 3.22x |
| 94664 | Demonstration and/or evaluation of patient use of aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (IPPB) device | 3.9K | $63.2K | $16.10 | 3.11x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 435 | $60.1K | $138.17 | 2.18x |
| 99239 | Hospital discharge day management, more than 30 minutes | 574 | $52.7K | $91.76 | 2.18x |
This provider submits charges 2.49 times higher than what Medicare actually pays.
A markup ratio of 2.49x means for every $100 Medicare pays, this provider initially charges $249. 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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