Statistical flag only — not an accusation of fraud
This provider's $45.7M in total Medicare payments ranks in the 99th percentile of General Practice providers nationally.
Medicare payments to this provider grew 32709% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 66/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 7349% in 2022
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 |
|---|---|---|---|---|---|---|---|
| 2014 | $207.80 | $84.30 | 2.47x | $123.50 | $101.2K | 1.2K | 16 |
| 2015 | $190.23 | $85.70 | 2.22x | $104.53 | $253.9K | 3.0K | 19 |
| 2016 | $212.37 | $83.73 | 2.54x | $128.64 | $178.9K | 2.1K | 21 |
| 2017 | $185.92 | $83.05 | 2.24x | $102.87 | $297.0K | 3.6K | 16 |
| 2018 | $184.61 | $79.02 | 2.34x | $105.59 | $256.4K | 3.2K | 17 |
| 2019 | $192.62 | $76.55 | 2.52x | $116.07 | $249.1K | 3.3K | 15 |
| 2020 | $184.95 | $73.29 | 2.52x | $111.66 | $330.8K | 4.5K | 16 |
| 2021 | $160.27 | $73.79 | 2.17x | $86.48 | $143.4K | 1.9K | 11 |
| 2022 | $719.78 | $469.70 | 1.53x | $250.08 | $10.7M | 22.7K | 18 |
| 2023 | $1.1K | $778.40 | 1.42x | $328.86 | $33.2M | 42.7K | 16 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4262 | Dual layer impax membrane, per square centimeter | 23.7K | $23.2M | $976.76 | 1.35x |
| Q4253 | Zenith amniotic membrane, per square centimeter | 19.7K | $16.8M | $853.44 | 1.48x |
| Q4205 | Membrane graft or membrane wrap, per square centimeter | 8.8K | $2.6M | $293.75 | 1.53x |
| 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 | 8.0K | $676.7K | $84.14 | 2.14x |
| 99214 | Established patient outpatient visit, total time 30-39 minutes | 5.5K | $435.1K | $78.47 | 2.01x |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 1.9K | $264.0K | $142.24 | 3.03x |
| 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 | 1.6K | $182.3K | $117.54 | 2.76x |
| 97610 | Therapy procedure using ultrasound | 453 | $164.2K | $362.47 | 1.52x |
| A2014 | Omeza collagen matrix, per 100 mg | 1.8K | $130.5K | $73.46 | 1.36x |
| 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 | 3.7K | $119.6K | $32.60 | 2.29x |
| 93925 | Ultrasound study of arteries and arterial grafts of both legs | 642 | $117.2K | $182.57 | 2.15x |
| 93975 | Ultrasound scan of abdominal, pelvic, and/or scrotal arterial inflow and venous outflow | 535 | $112.3K | $209.87 | 2.32x |
| 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 | 2.6K | $109.8K | $41.80 | 2.20x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 643 | $99.7K | $155.07 | 3.70x |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 483 | $89.6K | $185.43 | 2.61x |
| 93930 | Ultrasound study of arteries and arterial grafts of both arms | 513 | $81.4K | $158.60 | 2.52x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 494 | $66.3K | $134.20 | 2.71x |
| 99345 | Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes | 309 | $50.5K | $163.36 | 2.63x |
| 76881 | Complete ultrasound of arm or leg | 483 | $38.3K | $79.25 | 3.15x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 340 | $36.4K | $107.16 | 1.95x |
This provider submits charges 1.49 times higher than what Medicare actually pays.
A markup ratio of 1.49x means for every $100 Medicare pays, this provider initially charges $149. 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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