This provider averages 64 services per working day
Based on 63.6K total services over 4 years (250 working days/year). Learn about impossible service volumes →
This provider's $5.6M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Averaging 64 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 76800% from 2020 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 12381% 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 |
|---|---|---|---|---|---|---|---|
| 2020 | $135.46 | $39.72 | 3.41x | $95.74 | $3.9K | 98 | 2 |
| 2021 | $164.05 | $98.48 | 1.67x | $65.57 | $485.8K | 4.9K | 13 |
| 2022 | $154.19 | $89.96 | 1.71x | $64.23 | $2.1M | 23.5K | 12 |
| 2023 | $149.14 | $85.53 | 1.74x | $63.61 | $3.0M | 35.0K | 11 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| G0181 | Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow | 22.5K | $2.0M | $87.62 | 1.77x |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 9.6K | $1.4M | $148.95 | 1.73x |
| 99345 | Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes | 4.1K | $661.8K | $161.93 | 1.91x |
| 99497 | Advance care planning, first 30 minutes | 5.7K | $440.5K | $77.53 | 1.62x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 1.5K | $271.3K | $179.53 | 1.38x |
| G0180 | Physician or allowed practitioner 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 and | 5.4K | $245.5K | $45.50 | 1.79x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 1.5K | $217.7K | $141.53 | 1.37x |
| G0179 | Physician or allowed practitioner 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 a | 4.7K | $167.6K | $35.75 | 1.74x |
| G0108 | Diabetes outpatient self-management training services, individual, per 30 minutes | 1.5K | $69.7K | $47.39 | 1.74x |
| 99473 | Education and training to self measure blood pressure | 5.9K | $66.8K | $11.26 | 1.65x |
| 99483 | Assessment of and care planning for patient with impaired thought processing, typically 50 minutes | 155 | $28.8K | $185.50 | 1.27x |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 408 | $14.5K | $35.55 | 2.31x |
| 99407 | Smoking and tobacco use intensive counseling, more than 10 minutes | 458 | $13.6K | $29.62 | 1.39x |
| 99212 | Established patient outpatient visit, total time 10-19 minutes | 74 | $2.4K | $32.72 | 3.82x |
| 99202 | New patient office or other outpatient visit, typically 20 minutes | 41 | $2.3K | $56.10 | 2.67x |
| P9604 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge | 62 | $626.20 | $10.10 | 1.49x |
This provider submits charges 1.73 times higher than what Medicare actually pays.
A markup ratio of 1.73x means for every $100 Medicare pays, this provider initially charges $173. 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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