This provider averages 61 services per working day
Based on 153.1K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $8.6M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Averaging 61 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 118% 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 | $112.29 | $53.09 | 2.12x | $59.20 | $521.4K | 10.9K | 2.5K |
| 2015 | $96.21 | $40.23 | 2.39x | $55.98 | $534.6K | 11.5K | 2.3K |
| 2016 | $102.46 | $41.11 | 2.49x | $61.35 | $739.4K | 15.4K | 2.9K |
| 2017 | $103.66 | $42.12 | 2.46x | $61.54 | $868.7K | 18.0K | 3.2K |
| 2018 | $133.45 | $41.41 | 3.22x | $92.04 | $770.6K | 15.5K | 5.7K |
| 2019 | $160.02 | $83.47 | 1.92x | $76.55 | $940.5K | 15.0K | 5.3K |
| 2020 | $159.51 | $86.52 | 1.84x | $72.99 | $1.1M | 17.0K | 5.3K |
| 2021 | $168.88 | $85.09 | 1.98x | $83.79 | $938.2K | 15.1K | 4.7K |
| 2022 | $187.36 | $73.01 | 2.57x | $114.35 | $1.0M | 16.7K | 5.0K |
| 2023 | $154.64 | $80.83 | 1.91x | $73.81 | $1.1M | 18.0K | 4.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 72.6K | $3.6M | $49.34 | 2.09x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 29.4K | $2.0M | $68.82 | 1.97x |
| 99334 | Established patient assisted living visit, typically 15 minutes | 17.2K | $692.3K | $40.23 | 3.61x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 5.9K | $605.2K | $102.57 | 1.90x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 3.4K | $312.4K | $91.49 | 2.19x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 4.0K | $264.9K | $66.47 | 2.35x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 1.8K | $228.3K | $124.82 | 1.94x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.3K | $125.1K | $38.36 | 2.41x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.5K | $99.5K | $64.47 | 2.07x |
| 99326 | New patient assisted living visit, typically 45 minutes | 970 | $90.8K | $93.65 | 2.22x |
| 99495 | Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge | 581 | $68.7K | $118.31 | 1.35x |
| 99347 | Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes | 1.6K | $50.3K | $30.56 | 2.35x |
| 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 | 1.3K | $45.8K | $36.13 | 2.71x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 1.4K | $44.7K | $31.65 | 2.26x |
| 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 | 1.5K | $40.3K | $26.60 | 2.74x |
| 99327 | New patient assisted living visit, typically 60 minutes | 222 | $29.5K | $132.92 | 2.21x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 322 | $28.9K | $89.69 | 1.92x |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 534 | $28.8K | $54.02 | 2.11x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 158 | $26.8K | $169.93 | 1.36x |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 133 | $25.9K | $194.77 | 10.27x |
This provider submits charges 2.21 times higher than what Medicare actually pays.
A markup ratio of 2.21x means for every $100 Medicare pays, this provider initially charges $221. 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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