This provider's $8.4M in total Medicare payments ranks in the 99th percentile of Physical Medicine and Rehabilitation providers nationally.
Medicare payments to this provider grew 66% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 76% in 2020
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 | $111.68 | $42.48 | 2.63x | $69.20 | $598.4K | 21.6K | 8.3K |
| 2015 | $210.62 | $71.56 | 2.94x | $139.06 | $745.3K | 9.6K | 2.9K |
| 2016 | $190.22 | $56.34 | 3.38x | $133.88 | $672.8K | 9.2K | 2.2K |
| 2017 | $214.75 | $65.69 | 3.27x | $149.06 | $656.4K | 9.3K | 2.3K |
| 2018 | $202.82 | $58.32 | 3.48x | $144.50 | $641.4K | 9.0K | 2.4K |
| 2019 | $295.19 | $76.36 | 3.87x | $218.83 | $618.1K | 8.7K | 2.3K |
| 2020 | $283.93 | $86.08 | 3.30x | $197.85 | $1.1M | 8.6K | 2.7K |
| 2021 | $276.42 | $91.59 | 3.02x | $184.83 | $1.2M | 8.6K | 2.6K |
| 2022 | $266.41 | $83.54 | 3.19x | $182.87 | $1.1M | 7.5K | 2.0K |
| 2023 | $271.89 | $85.28 | 3.19x | $186.61 | $991.1K | 7.2K | 2.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 35.8K | $2.9M | $81.81 | 2.62x |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 11.9K | $2.9M | $244.44 | 3.71x |
| 80307 | Testing for presence of drug | 8.7K | $615.9K | $71.20 | 6.18x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.9K | $390.1K | $56.67 | 2.58x |
| G0431 | Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter | 3.1K | $303.5K | $96.38 | 4.57x |
| G0479 | Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, TOF, MALDI, LDTD, DESI, DART, GHPC, GC mass spectrometry), includes sample validation when | 3.5K | $268.6K | $77.60 | 5.67x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.0K | $242.6K | $122.55 | 3.67x |
| 64445 | Injection of anesthetic agent, sciatic nerve | 1.1K | $131.7K | $116.00 | 2.84x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 1.5K | $70.7K | $47.72 | 2.64x |
| 20552 | Injections of trigger points in 1 or 2 muscles | 1.4K | $59.7K | $41.79 | 2.68x |
| 83925 | Opiates (drug) measurement | 1.4K | $35.3K | $25.98 | 2.04x |
| 95911 | Nerve transmission studies, 9-10 studies | 190 | $33.8K | $177.70 | 2.49x |
| 80154 | Benzodiazepines level | 1.3K | $33.3K | $24.66 | 2.07x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 1.0K | $31.5K | $30.93 | 2.49x |
| 83840 | Methadone level | 1.4K | $29.4K | $21.79 | 2.06x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 503 | $28.7K | $57.15 | 2.48x |
| 82145 | Amphetamine or methamphetamine level | 1.4K | $28.2K | $20.74 | 2.07x |
| 82520 | Cocaine (drug) level | 1.4K | $27.4K | $20.23 | 2.07x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 166 | $26.9K | $161.89 | 2.49x |
| 80299 | Quantitation of drug | 1.4K | $24.8K | $18.29 | 2.08x |
This provider submits charges 3.44 times higher than what Medicare actually pays.
A markup ratio of 3.44x means for every $100 Medicare pays, this provider initially charges $344. 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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