This provider's $4.6M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 233% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 174% in 2021
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 | $303.62 | $71.76 | 4.23x | $231.86 | $255.3K | 4.2K | 2.0K |
| 2015 | $270.92 | $64.25 | 4.22x | $206.67 | $355.2K | 5.5K | 2.0K |
| 2016 | $304.67 | $83.37 | 3.65x | $221.30 | $257.3K | 3.8K | 1.7K |
| 2017 | $253.48 | $73.17 | 3.46x | $180.31 | $175.8K | 3.0K | 1.4K |
| 2018 | $262.21 | $90.68 | 2.89x | $171.53 | $448.4K | 6.1K | 1.9K |
| 2019 | $326.87 | $81.54 | 4.01x | $245.33 | $408.7K | 5.8K | 1.7K |
| 2020 | $327.39 | $81.29 | 4.03x | $246.10 | $272.8K | 3.6K | 1.0K |
| 2021 | $308.18 | $73.20 | 4.21x | $234.98 | $747.5K | 12.5K | 1.2K |
| 2022 | $281.50 | $62.65 | 4.49x | $218.85 | $865.1K | 15.4K | 844 |
| 2023 | $284.74 | $67.37 | 4.23x | $217.37 | $849.4K | 14.5K | 828 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 20.7K | $1.2M | $56.72 | 1.76x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 12.3K | $908.8K | $73.79 | 3.87x |
| 49460 | Mechanical removal of obstructive material in stomach, large, or small bowel tube using fluoroscopic guidance with contrast | 9.0K | $357.2K | $39.90 | 2.51x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.9K | $331.7K | $56.06 | 4.03x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.0K | $247.0K | $82.10 | 3.47x |
| 99354 | Prolonged office or other outpatient service first hour | 2.5K | $194.8K | $77.90 | 3.15x |
| 20615 | Aspiration and injection treatment of bone cyst | 687 | $137.3K | $199.81 | 3.00x |
| 94060 | Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration | 2.9K | $126.4K | $43.81 | 6.32x |
| 11043 | Removal of skin and/or muscle first 20 sq cm or less | 954 | $123.8K | $129.79 | 3.46x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 1.1K | $113.7K | $105.05 | 3.04x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 749 | $113.4K | $151.34 | 3.30x |
| 11042 | Removal of skin and tissue first 20 sq cm or less | 2.1K | $104.0K | $49.42 | 2.43x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 726 | $103.8K | $142.99 | 2.52x |
| 11044 | Removal of skin and bone first 20 sq cm or less | 497 | $95.2K | $191.57 | 2.69x |
| 64520 | Injection of anesthetic agent, middle or lower spine sympathetic nerves | 596 | $92.3K | $154.86 | 2.42x |
| 93923 | Ultrasound study of arteries of both arms and legs | 762 | $55.4K | $72.65 | 3.44x |
| 93971 | Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers | 555 | $42.8K | $77.10 | 2.59x |
| 76700 | Ultrasound of abdomen | 380 | $37.3K | $98.22 | 4.58x |
| 94729 | Measurement of lung diffusing capacity | 692 | $29.3K | $42.32 | 7.09x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 2.0K | $24.7K | $12.29 | 6.51x |
This provider submits charges 3.23 times higher than what Medicare actually pays.
A markup ratio of 3.23x means for every $100 Medicare pays, this provider initially charges $323. 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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