This provider's $4.1M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 279% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 100% in 2015
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 | $224.39 | $92.40 | 2.43x | $131.99 | $144.9K | 1.8K | 1.3K |
| 2015 | $254.30 | $99.18 | 2.56x | $155.12 | $289.9K | 3.4K | 2.5K |
| 2016 | $301.83 | $97.98 | 3.08x | $203.85 | $376.8K | 4.7K | 3.0K |
| 2017 | $235.07 | $75.79 | 3.10x | $159.28 | $398.7K | 5.3K | 2.9K |
| 2018 | $205.91 | $68.92 | 2.99x | $136.99 | $418.9K | 6.8K | 3.3K |
| 2019 | $225.42 | $70.01 | 3.22x | $155.41 | $457.5K | 6.6K | 3.6K |
| 2020 | $175.24 | $57.28 | 3.06x | $117.96 | $439.0K | 7.6K | 3.5K |
| 2021 | $142.32 | $72.18 | 1.97x | $70.14 | $562.2K | 9.3K | 3.7K |
| 2022 | $135.16 | $64.92 | 2.08x | $70.24 | $497.8K | 7.7K | 3.3K |
| 2023 | $131.22 | $64.41 | 2.04x | $66.81 | $549.6K | 7.4K | 3.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 12.4K | $745.4K | $60.19 | 3.16x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 7.9K | $693.7K | $88.03 | 2.60x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 2.4K | $383.5K | $162.83 | 2.64x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.5K | $379.1K | $84.43 | 2.07x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 3.0K | $335.4K | $111.81 | 3.59x |
| 99238 | Hospital discharge day management, 30 minutes or less | 4.9K | $301.1K | $60.89 | 4.14x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 7.5K | $291.3K | $38.96 | 1.85x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 3.1K | $173.6K | $56.90 | 2.67x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 1.2K | $125.1K | $108.16 | 2.40x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 903 | $119.2K | $132.01 | 1.42x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.7K | $104.4K | $61.02 | 1.92x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 526 | $60.3K | $114.69 | 2.33x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 746 | $55.5K | $74.46 | 2.78x |
| 99439 | Chronic care management services, each additional 20 minutes of clinical staff time per calendar month | 1.4K | $50.9K | $36.85 | 2.03x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 358 | $50.0K | $139.53 | 2.56x |
| 99315 | Nursing facility discharge day management, 30 minutes or less | 533 | $32.2K | $60.45 | 2.68x |
| 99220 | Hospital observation care typically 70 minutes per day | 167 | $26.0K | $155.85 | 2.44x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 413 | $25.7K | $62.13 | 2.83x |
| 99239 | Hospital discharge day management, more than 30 minutes | 281 | $24.3K | $86.44 | 3.14x |
| 90662 | Vaccine for influenza for injection into muscle, split virus, preservation free | 177 | $12.2K | $68.79 | 1.09x |
This provider submits charges 2.75 times higher than what Medicare actually pays.
A markup ratio of 2.75x means for every $100 Medicare pays, this provider initially charges $275. 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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