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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodologyโ€ขDownload Data
  1. Home
  2. Providers
  3. Peter Tothy
๐ŸŽ—๏ธ
MDI

Peter Tothy, MD

NPI: 1023157278
Crown Point, IN
10 years of data
Hematology-Oncology
$1.8M
Total Payments
9.0K
Beneficiaries
129.9K
Services
20.17x
Markup Ratio

Peer Comparison

91th
percentile in specialty
This provider$1.8M
Specialty median$339.6K

๐Ÿ“‹ Key Findings

1Billed $1.8M over 10 years
220.17x markup ratio (above median)
3Risk score: 68 โ€” flagged for review
491th percentile in Hematology-Oncology by payments
552 services/day โ€” unusually high
610 procedures with >3x markup

โš ๏ธ Flagged for Review

Risk Score: 68
  • 28x specialty median spending
  • Markup 20.2x (specialty median: 4.0x)
  • 22x specialty median beneficiaries
  • 155x specialty median services
View Deep Dives โ†’Report Fraud โ†’

Statistical flag only โ€” not an accusation of fraud

This provider averages 52 services per working day

Based on 129.9K total services over 10 years (250 working days/year). Learn about impossible service volumes โ†’

๐Ÿ”Ž Data Analysis

This provider's $1.8M in total Medicare payments ranks in the 91th percentile of Hematology-Oncology providers nationally.

Their average markup ratio of 20.17x is significantly above the specialty median of 3.5x.

Averaging 52 services per working day raises questions about billing patterns.

Medicare payments to this provider grew 77% from 2014 to 2023.

This provider has been statistically flagged with a risk score of 68/100. Statistical flags are not accusations of fraud.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid โ€” the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$285.41$14.1520.17x$271.26$128.7K9.1K652
2015$285.41$14.1520.17x$271.26$139.7K9.9K708
2016$285.41$14.1520.17x$271.26$150.7K10.7K764
2017$285.41$14.1520.17x$271.26$161.7K11.4K819
2018$285.41$14.1520.17x$271.26$172.8K12.2K875
2019$285.41$14.1520.17x$271.26$183.8K13.0K931
2020$285.41$14.1520.17x$271.26$194.8K13.8K987
2021$285.41$14.1520.17x$271.26$205.8K14.6K1.0K
2022$285.41$14.1520.17x$271.26$216.9K15.3K1.1K
2023$285.41$14.1520.17x$271.26$227.9K16.1K1.2K

Top Procedures (10)

99213Office/outpatient visit, est patient, lowโš  20.8x markup
$627.5K
44.4K services$14.15/svc20.80x markup
99214Office/outpatient visit, est patient, moderateโš  17.1x markup
$313.7K
22.2K services$14.15/svc17.14x markup
99215Office/outpatient visit, est patient, highโš  22.0x markup
$209.2K
14.8K services$14.15/svc21.96x markup
99223Initial hospital care, high complexityโš  19.8x markup
$156.9K
11.1K services$14.15/svc19.75x markup
99232Subsequent hospital care, moderateโš  20.5x markup
$125.5K
8.9K services$14.15/svc20.54x markup
93000Electrocardiogram, completeโš  19.9x markup
$104.6K
7.4K services$14.15/svc19.92x markup
71046Chest X-ray, 2 viewsโš  17.2x markup
$89.6K
6.3K services$14.15/svc17.22x markup
80053Comprehensive metabolic panelโš  23.9x markup
$78.4K
5.5K services$14.15/svc23.87x markup
85025Complete blood count (CBC)โš  24.0x markup
$69.7K
4.9K services$14.15/svc23.99x markup
36415Venipunctureโš  22.0x markup
$62.7K
4.4K services$14.15/svc21.97x markup
Show detailed table โ–พ
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
99213Office/outpatient visit, est patient, low44.4K$627.5K$14.1520.80x
99214Office/outpatient visit, est patient, moderate22.2K$313.7K$14.1517.14x
99215Office/outpatient visit, est patient, high14.8K$209.2K$14.1521.96x
99223Initial hospital care, high complexity11.1K$156.9K$14.1519.75x
99232Subsequent hospital care, moderate8.9K$125.5K$14.1520.54x
93000Electrocardiogram, complete7.4K$104.6K$14.1519.92x
71046Chest X-ray, 2 views6.3K$89.6K$14.1517.22x
80053Comprehensive metabolic panel5.5K$78.4K$14.1523.87x
85025Complete blood count (CBC)4.9K$69.7K$14.1523.99x
36415Venipuncture4.4K$62.7K$14.1521.97x

Markup Analysis

Charge-to-Payment Ratio

20.17x

This provider submits charges 20.17 times higher than what Medicare actually pays.

What This Means

A markup ratio of 20.17x means for every $100 Medicare pays, this provider initially charges $2017. This is higher than the national average.

Location

Crown Point, IN

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

Similar Providers

Other Hematology-Oncology providers in IN for peer comparison.

Peter Tothy (you)
$1.8M
Mohamad Kassar, M.D.โš ๏ธ
$40.6M
Show detailed table โ–พ
ProviderLocationTotal PaymentsStatus
Mohamad Kassar, M.D.Dyer, IN$40.6Mโš ๏ธ Flagged

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Data Sources

  • โ€ข Centers for Medicare & Medicaid Services (CMS)
  • โ€ข Medicare Provider Utilization and Payment Data (2014-2023)
  • โ€ข National Plan and Provider Enumeration System (NPPES)

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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