This provider averages 54 services per working day
Based on 26.9K total services over 2 years (250 working days/year). Learn about impossible service volumes →
This provider's $24.0M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Averaging 54 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 89561% from 2022 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 89561% in 2023
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 |
|---|---|---|---|---|---|---|---|
| 2022 | $900.41 | $82.29 | 10.94x | $818.12 | $26.7K | 325 | 6 |
| 2023 | $1.2K | $901.34 | 1.37x | $332.13 | $24.0M | 26.6K | 15 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4262 | Dual layer impax membrane, per square centimeter | 11.4K | $12.1M | $1.1K | 1.37x |
| Q4205 | Membrane graft or membrane wrap, per square centimeter | 9.9K | $11.5M | $1.2K | 1.29x |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 3.0K | $172.0K | $56.45 | 3.81x |
| 15271 | Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less | 586 | $69.3K | $118.25 | 2.54x |
| 97610 | Therapy procedure using ultrasound | 155 | $52.5K | $338.64 | 2.95x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 281 | $27.9K | $99.29 | 2.42x |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 194 | $26.3K | $135.74 | 3.90x |
| 97597 | Removal of tissue from wound, 20.0 sq cm or less | 189 | $14.5K | $76.78 | 2.60x |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 168 | $13.2K | $78.67 | 10.65x |
| 99497 | Advance care planning, first 30 minutes | 195 | $11.2K | $57.23 | 4.23x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 127 | $8.7K | $68.31 | 3.81x |
| 99345 | Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes | 54 | $8.4K | $155.38 | 2.54x |
| 99239 | Hospital discharge day management, more than 30 minutes | 85 | $6.7K | $79.28 | 11.29x |
| 97598 | Removal of tissue from wound, each additional 20.0 sq cm | 156 | $5.3K | $34.19 | 5.85x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 50 | $4.9K | $97.50 | 3.97x |
| 99344 | Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes | 42 | $4.6K | $109.12 | 2.75x |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 28 | $3.6K | $128.55 | 12.65x |
| 99220 | Initial hospital observation care per day, typically 70 minutes | 23 | $3.1K | $133.37 | 11.18x |
| 15272 | Application of skin substitute graft to wound of trunk, arms, or legs, each additional 25.0 sq cm of wound 100.0 sq cm or less | 133 | $2.5K | $18.48 | 4.30x |
| 99217 | Hospital observation care on day of discharge | 45 | $2.4K | $53.64 | 10.90x |
This provider submits charges 1.38 times higher than what Medicare actually pays.
A markup ratio of 1.38x means for every $100 Medicare pays, this provider initially charges $138. 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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