This provider averages 91 services per working day
Based on 227.9K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $13.1M in total Medicare payments ranks in the 99th percentile of Pulmonary Disease providers nationally.
Averaging 91 services per working day raises questions about billing patterns.
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 | $546.67 | $81.77 | 6.69x | $464.90 | $1.2M | 14.6K | 6.2K |
| 2015 | $520.06 | $78.34 | 6.64x | $441.72 | $1.5M | 19.1K | 7.9K |
| 2016 | $488.06 | $70.78 | 6.90x | $417.28 | $1.4M | 20.1K | 8.7K |
| 2017 | $491.48 | $66.97 | 7.34x | $424.51 | $1.5M | 21.5K | 8.9K |
| 2018 | $470.45 | $63.33 | 7.43x | $407.12 | $1.3M | 19.6K | 8.3K |
| 2019 | $332.60 | $51.40 | 6.47x | $281.20 | $1.2M | 20.5K | 10.6K |
| 2020 | $322.04 | $46.37 | 6.95x | $275.67 | $1.2M | 20.6K | 10.1K |
| 2021 | $295.56 | $43.68 | 6.77x | $251.88 | $1.3M | 25.9K | 13.1K |
| 2022 | $311.41 | $40.43 | 7.70x | $270.98 | $1.2M | 33.1K | 15.7K |
| 2023 | $313.54 | $42.83 | 7.32x | $270.71 | $1.3M | 32.9K | 16.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 30.6K | $1.9M | $61.21 | 4.09x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 11.5K | $1.3M | $112.90 | 3.54x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 5.4K | $1.0M | $185.40 | 2.70x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 13.9K | $905.5K | $64.95 | 3.85x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 14.5K | $891.3K | $61.27 | 3.27x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 9.5K | $730.5K | $76.73 | 3.26x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 5.5K | $625.6K | $114.04 | 2.63x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 6.3K | $566.2K | $90.11 | 3.34x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 4.4K | $542.6K | $122.65 | 7.34x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.8K | $439.4K | $92.32 | 3.25x |
| 94750 | Measurement of lung stretching capacity | 4.8K | $355.2K | $74.38 | 2.69x |
| 94729 | Measurement of lung diffusing capacity | 6.7K | $332.8K | $49.83 | 6.02x |
| 94060 | Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration | 6.7K | $330.7K | $49.70 | 1.61x |
| 94726 | Determination of lung volumes using plethysmography | 6.6K | $308.8K | $47.09 | 6.37x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 1.4K | $189.9K | $137.64 | 3.63x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 4.3K | $165.6K | $38.41 | 5.21x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 952 | $164.9K | $173.20 | 2.88x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 968 | $133.6K | $138.05 | 2.18x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.1K | $132.9K | $125.37 | 3.56x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 1.2K | $129.2K | $109.44 | 2.29x |
This provider submits charges 4.35 times higher than what Medicare actually pays.
A markup ratio of 4.35x means for every $100 Medicare pays, this provider initially charges $435. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
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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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