This provider's $4.2M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 25558% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 9589% 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 | $105.00 | $63.15 | 1.66x | $41.85 | $2.4K | 40 | 39 |
| 2015 | $70.88 | $49.87 | 1.42x | $21.01 | $233.4K | 4.1K | 2.9K |
| 2016 | $75.50 | $47.38 | 1.59x | $28.12 | $275.7K | 5.0K | 3.5K |
| 2017 | $78.37 | $53.08 | 1.48x | $25.29 | $370.7K | 6.9K | 4.9K |
| 2018 | $88.20 | $58.13 | 1.52x | $30.07 | $454.0K | 8.1K | 6.2K |
| 2019 | $83.38 | $58.21 | 1.43x | $25.17 | $507.4K | 8.5K | 6.5K |
| 2020 | $77.57 | $56.02 | 1.38x | $21.55 | $583.4K | 9.4K | 7.2K |
| 2021 | $112.19 | $79.35 | 1.41x | $32.84 | $583.1K | 9.2K | 7.0K |
| 2022 | $81.56 | $53.72 | 1.52x | $27.84 | $601.7K | 8.8K | 7.0K |
| 2023 | $100.83 | $70.26 | 1.44x | $30.57 | $618.0K | 8.2K | 7.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 13.8K | $1.1M | $78.34 | 1.63x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 6.9K | $869.7K | $125.70 | 1.06x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 6.9K | $579.5K | $84.41 | 1.16x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 12.1K | $561.0K | $46.54 | 1.96x |
| 90662 | Vaccine for influenza for injection into muscle | 3.4K | $195.5K | $57.29 | 1.15x |
| 90670 | Pneumococcal vaccine for injection into muscle | 849 | $156.9K | $184.86 | 1.07x |
| G0444 | Annual depression screening, 15 minutes | 6.9K | $132.8K | $19.14 | 1.48x |
| 90732 | Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older | 890 | $95.4K | $107.14 | 1.04x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 506 | $87.9K | $173.71 | 1.06x |
| G0008 | Administration of influenza virus vaccine | 3.5K | $84.1K | $24.09 | 1.27x |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 241 | $67.3K | $279.15 | 1.04x |
| G0009 | Administration of pneumococcal vaccine | 2.0K | $45.6K | $23.21 | 1.38x |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 264 | $44.1K | $166.86 | 1.08x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 360 | $39.7K | $110.23 | 1.73x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 2.8K | $36.2K | $13.14 | 2.29x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 458 | $26.5K | $57.85 | 2.18x |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 133 | $16.2K | $121.58 | 1.03x |
| 17000 | Destruction of skin growth | 357 | $15.3K | $42.80 | 2.16x |
| 69210 | Removal of impact ear wax, one ear | 377 | $12.4K | $32.86 | 1.99x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 102 | $11.2K | $110.26 | 1.45x |
This provider submits charges 1.41 times higher than what Medicare actually pays.
A markup ratio of 1.41x means for every $100 Medicare pays, this provider initially charges $141. This is lower 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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