This provider's $5.3M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 356% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 87% in 2021
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 | $117.97 | $50.13 | 2.35x | $67.84 | $278.3K | 3.9K | 2.0K |
| 2015 | $153.44 | $67.15 | 2.29x | $86.29 | $231.4K | 2.8K | 2.2K |
| 2016 | $146.36 | $61.51 | 2.38x | $84.85 | $230.9K | 3.1K | 2.2K |
| 2017 | $155.04 | $54.40 | 2.85x | $100.64 | $248.6K | 3.4K | 2.4K |
| 2018 | $154.29 | $56.59 | 2.73x | $97.70 | $340.9K | 5.0K | 2.7K |
| 2019 | $147.14 | $55.27 | 2.66x | $91.87 | $393.2K | 6.1K | 2.6K |
| 2020 | $152.48 | $59.72 | 2.55x | $92.76 | $448.4K | 7.1K | 2.3K |
| 2021 | $162.33 | $73.06 | 2.22x | $89.27 | $837.2K | 12.3K | 3.0K |
| 2022 | $163.21 | $67.90 | 2.40x | $95.31 | $1.1M | 15.8K | 3.8K |
| 2023 | $172.33 | $80.51 | 2.14x | $91.82 | $1.3M | 18.0K | 4.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 46.3K | $2.9M | $62.73 | 3.93x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 7.4K | $1.1M | $146.21 | 1.85x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.3K | $480.4K | $90.46 | 2.20x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.4K | $203.4K | $59.97 | 2.89x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 1.1K | $157.4K | $138.81 | 1.80x |
| G0180 | Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple | 2.9K | $135.7K | $47.58 | 2.10x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 1.6K | $120.9K | $74.51 | 2.35x |
| 99309 | Follow-up nursing facility visit per day, typically 25 minutes | 1.0K | $88.6K | $87.95 | 2.27x |
| 99315 | Nursing facility discharge day management, 30 minutes or less | 1.1K | $76.2K | $66.99 | 2.28x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 268 | $30.8K | $114.95 | 3.04x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 1.8K | $22.7K | $12.31 | 6.13x |
| 36415 | Insertion of needle into vein for collection of blood sample | 3.1K | $11.5K | $3.71 | 5.41x |
| G0179 | Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial im | 303 | $10.9K | $36.11 | 2.77x |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 47 | $8.6K | $183.81 | 1.43x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 316 | $5.1K | $16.04 | 3.12x |
| 81002 | Urinalysis, manual test | 1.3K | $4.4K | $3.43 | 5.94x |
| G0008 | Administration of influenza virus vaccine | 55 | $1.6K | $28.46 | 1.23x |
| 90688 | Vaccine for influenza administered into muscle to individuals 3 years of age and older | 58 | $1.0K | $17.83 | 2.78x |
| 90661 | Vaccine for influenza for injection into muscle | 14 | $305.76 | $21.84 | 2.29x |
| G0403 | Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report | 27 | $276.01 | $10.22 | 7.34x |
This provider submits charges 3.12 times higher than what Medicare actually pays.
A markup ratio of 3.12x means for every $100 Medicare pays, this provider initially charges $312. 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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