This provider's $3.4M in total Medicare payments ranks in the 99th percentile of Critical Care (Intensivists) providers nationally.
Medicare payments to this provider grew 252% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 100% in 2022
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 | $375.00 | $115.16 | 3.26x | $259.84 | $164.7K | 1.5K | 591 |
| 2015 | $375.00 | $118.03 | 3.18x | $256.97 | $225.0K | 1.9K | 746 |
| 2016 | $488.48 | $103.90 | 4.70x | $384.58 | $198.8K | 1.8K | 842 |
| 2017 | $341.97 | $87.14 | 3.92x | $254.83 | $365.0K | 4.6K | 1.8K |
| 2018 | $352.73 | $89.56 | 3.94x | $263.17 | $245.8K | 3.2K | 1.3K |
| 2019 | $344.09 | $87.52 | 3.93x | $256.57 | $287.6K | 4.3K | 1.4K |
| 2020 | $342.70 | $90.79 | 3.77x | $251.91 | $241.8K | 3.5K | 1.1K |
| 2021 | $361.36 | $95.28 | 3.79x | $266.08 | $373.9K | 4.0K | 1.2K |
| 2022 | $287.31 | $107.22 | 2.68x | $180.09 | $746.4K | 6.3K | 1.4K |
| 2023 | $205.07 | $112.56 | 1.82x | $92.51 | $579.1K | 5.5K | 1.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 5.2K | $1.1M | $204.67 | 2.33x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 12.1K | $795.3K | $65.78 | 2.22x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 8.0K | $517.5K | $64.96 | 2.18x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.7K | $302.0K | $178.60 | 1.95x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.9K | $184.2K | $94.72 | 2.07x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 2.7K | $104.5K | $39.29 | 3.82x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 345 | $52.7K | $152.83 | 1.91x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 544 | $51.1K | $93.88 | 2.51x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 399 | $48.2K | $120.73 | 1.65x |
| 99239 | Hospital discharge day management, more than 30 minutes | 432 | $41.5K | $95.95 | 2.07x |
| 95811 | Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube | 288 | $31.9K | $110.72 | 12.76x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 357 | $31.0K | $86.97 | 1.74x |
| 95810 | Sleep monitoring of patient (6 years or older) in sleep lab | 269 | $28.7K | $106.55 | 13.34x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 189 | $22.1K | $117.09 | 2.13x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 158 | $20.5K | $129.84 | 1.91x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 110 | $16.6K | $151.31 | 2.69x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 270 | $15.3K | $56.65 | 3.03x |
| 99334 | Established patient assisted living visit, typically 15 minutes | 265 | $12.4K | $46.98 | 3.19x |
| 95800 | Sleep study including heart rate, breathing, and sleep time | 84 | $12.2K | $145.34 | 2.00x |
| 94621 | Pulmonary exercise testing | 81 | $11.6K | $143.39 | 3.45x |
This provider submits charges 2.49 times higher than what Medicare actually pays.
A markup ratio of 2.49x means for every $100 Medicare pays, this provider initially charges $249. 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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