This provider's $4.2M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 140% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 55% in 2023
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 | $281.68 | $81.93 | 3.44x | $199.75 | $289.3K | 4.4K | 3.0K |
| 2015 | $186.34 | $72.02 | 2.59x | $114.32 | $294.4K | 4.3K | 3.1K |
| 2016 | $178.00 | $70.31 | 2.53x | $107.69 | $321.1K | 5.0K | 3.8K |
| 2017 | $196.13 | $77.54 | 2.53x | $118.59 | $414.5K | 5.8K | 4.6K |
| 2018 | $196.80 | $76.93 | 2.56x | $119.87 | $382.2K | 5.6K | 4.3K |
| 2019 | $200.00 | $83.22 | 2.40x | $116.78 | $409.9K | 5.7K | 4.5K |
| 2020 | $203.69 | $90.52 | 2.25x | $113.17 | $401.1K | 5.7K | 4.4K |
| 2021 | $196.82 | $85.40 | 2.30x | $111.42 | $547.5K | 6.7K | 5.3K |
| 2022 | $196.18 | $88.94 | 2.21x | $107.24 | $446.4K | 6.0K | 4.6K |
| 2023 | $192.30 | $78.94 | 2.44x | $113.36 | $693.5K | 9.3K | 7.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 12.4K | $899.4K | $72.41 | 2.31x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 13.9K | $707.6K | $50.77 | 2.25x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 4.3K | $543.4K | $126.09 | 1.98x |
| 93925 | Ultrasound study of arteries and arterial grafts of both legs | 2.1K | $396.7K | $191.25 | 2.35x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 2.1K | $303.6K | $146.87 | 3.06x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 1.9K | $211.3K | $109.11 | 5.50x |
| 93923 | Ultrasound study of arteries of both arms and legs | 2.1K | $179.5K | $86.69 | 4.00x |
| 90662 | Vaccine for influenza for injection into muscle | 2.5K | $149.7K | $60.00 | 1.09x |
| 93978 | Ultrasound scan of vena cava or groin graft or vessel blood flow | 827 | $113.2K | $136.92 | 3.29x |
| G0008 | Administration of influenza virus vaccine | 4.4K | $106.8K | $24.03 | 1.46x |
| 90670 | Pneumococcal vaccine for injection into muscle | 410 | $82.0K | $199.98 | 1.15x |
| 90653 | Vaccine for influenza for injection into muscle | 1.2K | $65.8K | $53.46 | 1.26x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 374 | $63.9K | $170.79 | 1.69x |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 266 | $45.1K | $169.65 | 1.77x |
| 90732 | Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older | 425 | $43.9K | $103.36 | 1.30x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 346 | $36.1K | $104.31 | 2.46x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 150 | $33.4K | $222.91 | 1.57x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 887 | $29.2K | $32.87 | 2.84x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 2.4K | $25.3K | $10.34 | 8.22x |
| G0009 | Administration of pneumococcal vaccine | 907 | $20.9K | $23.00 | 1.52x |
This provider submits charges 2.48 times higher than what Medicare actually pays.
A markup ratio of 2.48x means for every $100 Medicare pays, this provider initially charges $248. 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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