This provider's $4.8M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 621% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 79% in 2017
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 | $138.69 | $62.08 | 2.23x | $76.61 | $91.5K | 1.5K | 1.1K |
| 2015 | $119.92 | $79.89 | 1.50x | $40.03 | $159.9K | 2.3K | 1.6K |
| 2016 | $123.93 | $74.76 | 1.66x | $49.17 | $195.0K | 2.8K | 2.0K |
| 2017 | $106.97 | $71.36 | 1.50x | $35.61 | $349.1K | 4.7K | 3.4K |
| 2018 | $117.93 | $72.97 | 1.62x | $44.96 | $560.6K | 7.8K | 5.3K |
| 2019 | $110.44 | $70.96 | 1.56x | $39.48 | $441.3K | 6.1K | 4.5K |
| 2020 | $95.07 | $62.80 | 1.51x | $32.27 | $664.0K | 9.7K | 6.9K |
| 2021 | $107.49 | $66.84 | 1.61x | $40.65 | $893.6K | 10.4K | 7.3K |
| 2022 | $120.92 | $67.30 | 1.80x | $53.62 | $773.3K | 9.1K | 6.3K |
| 2023 | $119.31 | $69.14 | 1.73x | $50.17 | $659.5K | 7.8K | 5.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 21.9K | $1.7M | $79.87 | 1.86x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 7.6K | $954.6K | $125.67 | 1.30x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 14.8K | $809.1K | $54.73 | 1.87x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.8K | $215.1K | $116.80 | 1.77x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 915 | $183.8K | $200.83 | 1.54x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 834 | $142.2K | $170.54 | 1.29x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.2K | $127.7K | $107.69 | 1.92x |
| 99495 | Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge | 682 | $100.5K | $147.38 | 1.59x |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 574 | $95.9K | $167.07 | 1.29x |
| 90694 | Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, for injection into muscle, 0.5 ml dosage | 952 | $66.9K | $70.28 | 1.71x |
| 90653 | Vaccine for influenza for injection into muscle | 1.2K | $65.5K | $54.42 | 1.07x |
| G0008 | Administration of influenza virus vaccine | 2.7K | $59.5K | $22.25 | 1.64x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 672 | $42.6K | $63.38 | 2.35x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 973 | $31.0K | $31.89 | 1.98x |
| 99443 | Physician telephone patient service, 21-30 minutes of medical discussion | 278 | $23.6K | $84.82 | 1.77x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 431 | $20.4K | $47.26 | 1.76x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 316 | $17.4K | $55.06 | 1.80x |
| 99441 | Physician telephone patient service, 5-10 minutes of medical discussion | 498 | $16.2K | $32.48 | 1.94x |
| 69210 | Removal of impact ear wax, one ear | 421 | $14.1K | $33.52 | 2.00x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 1.0K | $11.4K | $11.44 | 2.91x |
This provider submits charges 1.69 times higher than what Medicare actually pays.
A markup ratio of 1.69x means for every $100 Medicare pays, this provider initially charges $169. This is lower 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.
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data