This provider's $3.8M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $108.24 | $44.65 | 2.42x | $63.59 | $541.4K | 9.1K | 6.2K |
| 2015 | $124.40 | $47.56 | 2.62x | $76.84 | $506.6K | 10.2K | 6.6K |
| 2016 | $119.07 | $49.04 | 2.43x | $70.03 | $495.0K | 9.9K | 6.3K |
| 2017 | $120.77 | $52.17 | 2.31x | $68.60 | $549.0K | 10.7K | 6.8K |
| 2018 | $142.01 | $48.29 | 2.94x | $93.72 | $369.7K | 7.0K | 4.7K |
| 2019 | $143.23 | $45.48 | 3.15x | $97.75 | $272.4K | 7.1K | 3.7K |
| 2020 | $141.34 | $44.05 | 3.21x | $97.29 | $239.4K | 6.8K | 3.1K |
| 2021 | $141.78 | $48.26 | 2.94x | $93.52 | $284.7K | 6.8K | 3.0K |
| 2022 | $149.87 | $49.08 | 3.05x | $100.79 | $253.8K | 6.4K | 2.5K |
| 2023 | $144.78 | $47.17 | 3.07x | $97.61 | $277.0K | 7.1K | 2.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 24.4K | $932.7K | $38.25 | 1.74x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 3.5K | $679.9K | $193.75 | 2.80x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 3.5K | $609.4K | $173.02 | 1.52x |
| 76700 | Ultrasound of abdomen | 4.0K | $444.0K | $110.31 | 2.92x |
| 76536 | Ultrasound of head and neck | 3.9K | $404.9K | $104.29 | 3.05x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 9.2K | $137.1K | $14.87 | 4.04x |
| 76872 | Ultrasound of rectum | 1.4K | $130.7K | $94.06 | 3.45x |
| 76856 | Ultrasound of pelvis | 2.1K | $127.4K | $59.90 | 5.37x |
| 90662 | Vaccine for influenza for injection into muscle | 1.8K | $74.2K | $41.41 | 1.37x |
| 96374 | Injection of drug or substance into a vein for therapy, diagnosis, or prevention | 1.4K | $59.0K | $40.94 | 2.13x |
| G0008 | Administration of influenza virus vaccine | 1.5K | $30.2K | $19.62 | 1.03x |
| 82962 | Blood glucose (sugar) test performed by hand-held instrument | 9.2K | $29.3K | $3.19 | 5.34x |
| 90740 | Vaccine for Hepatitis B (3 dose schedule) for injection into muscle, dialysis or immunosuppressed patient | 199 | $25.0K | $125.88 | 1.34x |
| 36415 | Insertion of needle into vein for collection of blood sample | 5.5K | $18.3K | $3.35 | 3.55x |
| 94644 | Respiratory inhaled aerosol treatment to relieve airway obstruction, first hour | 465 | $17.3K | $37.28 | 1.51x |
| 96360 | Hydration infusion into a vein 31 minutes to 1 hour | 340 | $13.8K | $40.71 | 2.32x |
| 90670 | Pneumococcal vaccine for injection into muscle | 73 | $12.8K | $175.47 | 1.27x |
| J2920 | Injection, methylprednisolone sodium succinate, up to 40 mg | 2.8K | $8.0K | $2.91 | 6.88x |
| 96361 | Hydration infusion into a vein | 341 | $4.2K | $12.44 | 5.17x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 21 | $3.7K | $176.61 | 1.41x |
This provider submits charges 2.53 times higher than what Medicare actually pays.
A markup ratio of 2.53x means for every $100 Medicare pays, this provider initially charges $253. 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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