This provider's $5.6M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 111% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 52% 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 | $189.21 | $74.71 | 2.53x | $114.50 | $351.9K | 4.8K | 2.6K |
| 2015 | $190.65 | $76.07 | 2.51x | $114.58 | $374.7K | 5.1K | 2.9K |
| 2016 | $189.26 | $72.37 | 2.62x | $116.89 | $316.2K | 4.8K | 2.6K |
| 2017 | $188.30 | $78.17 | 2.41x | $110.13 | $479.3K | 6.7K | 3.5K |
| 2018 | $186.75 | $76.05 | 2.46x | $110.70 | $623.0K | 8.2K | 3.8K |
| 2019 | $173.69 | $72.96 | 2.38x | $100.73 | $482.7K | 7.1K | 3.6K |
| 2020 | $172.72 | $77.33 | 2.23x | $95.39 | $674.8K | 11.4K | 4.1K |
| 2021 | $166.59 | $77.52 | 2.15x | $89.07 | $704.0K | 11.0K | 4.5K |
| 2022 | $169.49 | $89.43 | 1.90x | $80.06 | $840.3K | 12.1K | 3.5K |
| 2023 | $158.05 | $73.39 | 2.15x | $84.66 | $741.8K | 10.9K | 3.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99490 | Chronic care management services at least 20 minutes per calendar month | 30.9K | $1.4M | $45.90 | 1.49x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 7.4K | $698.8K | $94.17 | 2.15x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.5K | $541.9K | $71.96 | 2.10x |
| 99349 | Established patient home visit, typically 40 minutes | 4.1K | $442.1K | $107.33 | 2.56x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.9K | $350.0K | $179.49 | 1.97x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 2.2K | $265.8K | $123.50 | 2.07x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.6K | $249.2K | $96.31 | 2.36x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 1.9K | $209.3K | $112.61 | 2.26x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 1.5K | $205.9K | $139.04 | 1.45x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 3.1K | $204.5K | $65.44 | 3.07x |
| 99239 | Hospital discharge day management, more than 30 minutes | 1.9K | $188.9K | $98.72 | 2.11x |
| 99238 | Hospital discharge day management, 30 minutes or less | 2.5K | $163.9K | $66.29 | 2.97x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 486 | $94.8K | $195.01 | 1.26x |
| 99344 | New patient home visit, typically 60 minutes | 415 | $60.6K | $146.02 | 2.69x |
| 99350 | Established patient home visit, typically 60 minutes | 408 | $59.4K | $145.53 | 2.74x |
| 99219 | Hospital observation care typically 50 minutes | 358 | $43.2K | $120.73 | 2.23x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 325 | $26.2K | $80.52 | 1.87x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 297 | $25.5K | $85.80 | 1.53x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 276 | $23.7K | $85.94 | 2.73x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 191 | $22.0K | $115.16 | 2.99x |
This provider submits charges 2.08 times higher than what Medicare actually pays.
A markup ratio of 2.08x means for every $100 Medicare pays, this provider initially charges $208. 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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