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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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Methodology•Download Data
  1. Home
  2. Providers
  3. Thai Phou
⚕️
PAIndividual

Thai Phou, PA-C

NPI: 1023319746
Fountain Valley, CA
4 years of data
Physician Assistant
$5.7M
Total Payments
31
Beneficiaries
56.8K
Services
1.5x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$5.7M
Specialty median$22.5K

📋 Key Findings

1Billed $5.7M over 4 years
299th percentile in Physician Assistant by payments
357 services/day — unusually high
4Payments surged 1525% in 2023
511 procedures with >3x markup

This provider averages 57 services per working day

Based on 56.8K total services over 4 years (250 working days/year). Learn about impossible service volumes →

🔎 Data Analysis

This provider's $5.7M in total Medicare payments ranks in the 99th percentile of Physician Assistant providers nationally.

Averaging 57 services per working day raises questions about billing patterns.

Medicare payments to this provider grew 2721% from 2020 to 2023.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

📈

Notable: Payments increased 1525% in 2023

Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.

Submitted Charges vs. Medicare Payments

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

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2020$33.18$15.912.09x$17.27$167.3K10.5K5
2021$47.73$22.222.15x$25.51$491.5K22.1K8
2022$43.45$15.832.74x$27.62$290.3K18.3K5
2023$1.1K$815.691.33x$271.83$4.7M5.8K13

Top Procedures (20)

Q4205Membrane graft or membrane wrap, per square centimeter
$2.5M
2.3K services$1.1K/svc1.28x markup
Q4221Amniowrap2, per square centimeter
$1.4M
1.4K services$990.98/svc1.28x markup
Q4204Xwrap, per square centimeter
$737.6K
672 services$1.1K/svc1.28x markup
J7320Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg
$626.2K
46.5K services$13.45/svc1.78x markup
Q4177Floweramnioflo, 0.1 cc
$143.6K
1.0K services$143.57/svc1.39x markup
20611Aspiration and/or injection of fluid large joint using ultrasound guidance⚠ 5.9x markup
$129.4K
1.4K services$91.94/svc5.94x markup
15271Application 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⚠ 3.2x markup
$34.9K
301 services$116.06/svc3.24x markup
99214Established patient office or other outpatient visit, 30-39 minutes
$22.8K
262 services$87.03/svc2.40x markup
99348Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes⚠ 3.7x markup
$22.3K
414 services$53.83/svc3.73x markup
11043Removal of muscle and/or tissue, 20.0 sq cm or less⚠ 3.6x markup
$19.6K
126 services$155.56/svc3.63x markup
99349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes⚠ 3.4x markup
$12.7K
140 services$90.72/svc3.41x markup
J7329Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg
$11.9K
1.2K services$9.91/svc1.51x markup
11042Removal of skin and tissue, 20.0 sq cm or less⚠ 3.2x markup
$10.4K
105 services$98.85/svc3.18x markup
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes⚠ 3.1x markup
$10.4K
193 services$53.72/svc3.07x markup
99213Established patient outpatient visit, total time 20-29 minutes
$9.6K
169 services$56.89/svc2.44x markup
99204New patient office or other outpatient visit, 45-59 minutes
$4.9K
41 services$118.91/svc2.84x markup
99342Residence visit for new patient with low level of medical decision making, per day, if using time, at least 30 minutes⚠ 3.5x markup
$4.5K
86 services$52.68/svc3.53x markup
99344Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes⚠ 4.6x markup
$3.9K
41 services$95.26/svc4.57x markup
15272Application of skin substitute graft to wound of trunk, arms, or legs, each additional 25.0 sq cm of wound 100.0 sq cm or less⚠ 3.4x markup
$819.26
46 services$17.81/svc3.43x markup
99203New patient outpatient visit, total time 30-44 minutes⚠ 4.9x markup
$544.54
12 services$45.38/svc4.87x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
Q4205Membrane graft or membrane wrap, per square centimeter2.3K$2.5M$1.1K1.28x
Q4221Amniowrap2, per square centimeter1.4K$1.4M$990.981.28x
Q4204Xwrap, per square centimeter672$737.6K$1.1K1.28x
J7320Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg46.5K$626.2K$13.451.78x
Q4177Floweramnioflo, 0.1 cc1.0K$143.6K$143.571.39x
20611Aspiration and/or injection of fluid large joint using ultrasound guidance1.4K$129.4K$91.945.94x
15271Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less301$34.9K$116.063.24x
99214Established patient office or other outpatient visit, 30-39 minutes262$22.8K$87.032.40x
99348Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes414$22.3K$53.833.73x
11043Removal of muscle and/or tissue, 20.0 sq cm or less126$19.6K$155.563.63x
99349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes140$12.7K$90.723.41x
J7329Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg1.2K$11.9K$9.911.51x
11042Removal of skin and tissue, 20.0 sq cm or less105$10.4K$98.853.18x
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes193$10.4K$53.723.07x
99213Established patient outpatient visit, total time 20-29 minutes169$9.6K$56.892.44x
99204New patient office or other outpatient visit, 45-59 minutes41$4.9K$118.912.84x
99342Residence visit for new patient with low level of medical decision making, per day, if using time, at least 30 minutes86$4.5K$52.683.53x
99344Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes41$3.9K$95.264.57x
15272Application of skin substitute graft to wound of trunk, arms, or legs, each additional 25.0 sq cm of wound 100.0 sq cm or less46$819.26$17.813.43x
99203New patient outpatient visit, total time 30-44 minutes12$544.54$45.384.87x

Markup Analysis

Charge-to-Payment Ratio

1.5x

This provider submits charges 1.5 times higher than what Medicare actually pays.

What This Means

A markup ratio of 1.5x means for every $100 Medicare pays, this provider initially charges $150. This is lower than the national average.

Location

Fountain Valley, CA

Provider Verification

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

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • 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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