This provider's $3.2M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 88% from 2014 to 2023.
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 | $97.99 | $59.66 | 1.64x | $38.33 | $220.0K | 3.3K | 1.9K |
| 2015 | $95.52 | $57.33 | 1.67x | $38.19 | $257.0K | 4.2K | 3.1K |
| 2016 | $98.22 | $57.06 | 1.72x | $41.16 | $290.3K | 5.0K | 3.5K |
| 2017 | $96.62 | $53.98 | 1.79x | $42.64 | $313.3K | 5.6K | 4.0K |
| 2018 | $97.48 | $57.75 | 1.69x | $39.73 | $333.5K | 5.7K | 3.9K |
| 2019 | $104.34 | $61.57 | 1.69x | $42.77 | $335.7K | 5.3K | 3.9K |
| 2020 | $109.41 | $56.59 | 1.93x | $52.82 | $267.5K | 4.4K | 3.3K |
| 2021 | $129.23 | $81.39 | 1.59x | $47.84 | $377.2K | 4.7K | 3.5K |
| 2022 | $114.74 | $65.90 | 1.74x | $48.84 | $407.9K | 4.8K | 3.5K |
| 2023 | $99.60 | $56.35 | 1.77x | $43.25 | $414.1K | 5.2K | 3.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 14.5K | $1.1M | $78.14 | 1.95x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 10.6K | $564.6K | $53.10 | 1.96x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 3.6K | $469.7K | $129.89 | 1.32x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 2.8K | $312.5K | $109.73 | 1.88x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 850 | $148.8K | $175.09 | 1.32x |
| 90670 | Pneumococcal vaccine for injection into muscle | 670 | $120.2K | $179.36 | 1.31x |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 426 | $73.0K | $171.44 | 1.28x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 314 | $62.5K | $199.10 | 1.67x |
| G0008 | Administration of influenza virus vaccine | 2.5K | $58.8K | $23.48 | 1.39x |
| 90732 | Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older | 440 | $47.2K | $107.34 | 1.44x |
| 17000 | Destruction of skin growth | 540 | $26.2K | $48.44 | 2.24x |
| G0009 | Administration of pneumococcal vaccine | 1.1K | $25.9K | $23.34 | 1.37x |
| 90686 | Vaccine for influenza for administration into muscle, 0.5 ml dosage | 1.2K | $24.4K | $19.82 | 1.75x |
| 99495 | Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge | 109 | $15.5K | $141.78 | 1.69x |
| 90674 | Vaccine for influenza for administration into muscle, 0.5 ml dosage | 592 | $13.9K | $23.53 | 1.27x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 649 | $10.3K | $15.94 | 2.18x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 821 | $10.2K | $12.36 | 4.43x |
| G0444 | Annual depression screening, 15 minutes | 477 | $9.8K | $20.59 | 1.94x |
| 69210 | Removal of impact ear wax, one ear | 290 | $9.7K | $33.28 | 2.28x |
| G0442 | Annual alcohol misuse screening, 15 minutes | 443 | $9.2K | $20.81 | 2.16x |
This provider submits charges 1.77 times higher than what Medicare actually pays.
A markup ratio of 1.77x means for every $100 Medicare pays, this provider initially charges $177. 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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