This provider's $7.1M in total Medicare payments ranks in the 99th percentile of Geriatric Medicine providers nationally.
Medicare payments to this provider grew 97% 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 | $171.47 | $92.78 | 1.85x | $78.69 | $488.5K | 4.8K | 2.8K |
| 2015 | $172.35 | $85.89 | 2.01x | $86.46 | $726.8K | 7.0K | 4.4K |
| 2016 | $172.35 | $81.36 | 2.12x | $90.99 | $548.5K | 8.1K | 4.7K |
| 2017 | $150.59 | $70.80 | 2.13x | $79.79 | $412.9K | 7.4K | 3.3K |
| 2018 | $151.48 | $73.86 | 2.05x | $77.62 | $559.8K | 10.5K | 4.5K |
| 2019 | $136.13 | $72.50 | 1.88x | $63.63 | $737.9K | 13.3K | 4.6K |
| 2020 | $133.90 | $73.62 | 1.82x | $60.28 | $790.0K | 15.1K | 4.5K |
| 2021 | $163.40 | $80.83 | 2.02x | $82.57 | $939.0K | 15.3K | 4.6K |
| 2022 | $150.16 | $84.60 | 1.77x | $65.56 | $911.2K | 13.4K | 4.6K |
| 2023 | $128.79 | $65.95 | 1.95x | $62.84 | $961.7K | 15.0K | 4.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 18.3K | $1.7M | $91.79 | 2.11x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 40.9K | $1.5M | $37.26 | 1.90x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 3.8K | $473.2K | $126.06 | 1.58x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.7K | $286.7K | $60.52 | 2.21x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 5.8K | $286.3K | $49.47 | 2.73x |
| 99457 | Remote physiologic monitoring treatment management services, health care professional time in a calendar month requiring interactive communication with the patient/caregiver; first 20 minutes | 6.2K | $261.6K | $41.86 | 2.63x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 1.4K | $238.8K | $172.06 | 1.29x |
| 99337 | Established patient assisted living visit, typically 60 minutes | 1.4K | $206.5K | $147.71 | 1.96x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 1.0K | $204.2K | $202.35 | 1.86x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.5K | $184.9K | $122.52 | 2.35x |
| 99349 | Established patient home visit, typically 40 minutes | 1.6K | $160.6K | $100.95 | 1.88x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 979 | $154.4K | $157.71 | 2.18x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 1.2K | $129.8K | $105.99 | 2.37x |
| 99350 | Established patient home visit, typically 60 minutes | 839 | $119.6K | $142.54 | 2.07x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 1.5K | $103.6K | $68.04 | 1.90x |
| 90670 | Pneumococcal vaccine for injection into muscle | 486 | $96.1K | $197.67 | 1.24x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.1K | $87.8K | $82.07 | 2.36x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 535 | $69.7K | $130.30 | 2.51x |
| 99498 | Advance care planning by the physician or other qualified health care professional | 1.2K | $69.4K | $58.92 | 1.90x |
| 99495 | Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge | 375 | $50.5K | $134.54 | 2.60x |
This provider submits charges 2.03 times higher than what Medicare actually pays.
A markup ratio of 2.03x means for every $100 Medicare pays, this provider initially charges $203. 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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