Statistical flag only — not an accusation of fraud
This provider's $2.9M in total Medicare payments ranks in the 98th percentile of Pharmacy providers nationally.
Medicare payments to this provider grew 77% 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.
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 | $15.05 | $11.76 | 1.28x | $3.29 | $203.0K | 17.3K | 1.9K |
| 2015 | $15.05 | $11.76 | 1.28x | $3.29 | $220.5K | 18.7K | 2.1K |
| 2016 | $15.05 | $11.76 | 1.28x | $3.29 | $237.9K | 20.2K | 2.2K |
| 2017 | $15.05 | $11.76 | 1.28x | $3.29 | $255.3K | 21.7K | 2.4K |
| 2018 | $15.05 | $11.76 | 1.28x | $3.29 | $272.7K | 23.2K | 2.5K |
| 2019 | $15.05 | $11.76 | 1.28x | $3.29 | $290.1K | 24.7K | 2.7K |
| 2020 | $15.05 | $11.76 | 1.28x | $3.29 | $307.5K | 26.1K | 2.9K |
| 2021 | $15.05 | $11.76 | 1.28x | $3.29 | $324.9K | 27.6K | 3.0K |
| 2022 | $15.05 | $11.76 | 1.28x | $3.29 | $342.3K | 29.1K | 3.2K |
| 2023 | $15.05 | $11.76 | 1.28x | $3.29 | $359.7K | 30.6K | 3.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office/outpatient visit, est patient, low | 84.2K | $990.3K | $11.76 | 1.06x |
| 99214 | Office/outpatient visit, est patient, moderate | 42.1K | $495.2K | $11.76 | 1.33x |
| 99215 | Office/outpatient visit, est patient, high | 28.1K | $330.1K | $11.76 | 1.14x |
| 99223 | Initial hospital care, high complexity | 21.1K | $247.6K | $11.76 | 1.49x |
| 99232 | Subsequent hospital care, moderate | 16.8K | $198.1K | $11.76 | 1.48x |
| 93000 | Electrocardiogram, complete | 14.0K | $165.1K | $11.76 | 1.38x |
| 71046 | Chest X-ray, 2 views | 12.0K | $141.5K | $11.76 | 1.40x |
| 80053 | Comprehensive metabolic panel | 10.5K | $123.8K | $11.76 | 1.33x |
| 85025 | Complete blood count (CBC) | 9.4K | $110.0K | $11.76 | 1.23x |
| 36415 | Venipuncture | 8.4K | $99.0K | $11.76 | 1.44x |
This provider submits charges 1.28 times higher than what Medicare actually pays.
A markup ratio of 1.28x means for every $100 Medicare pays, this provider initially charges $128. This is lower than the national average.
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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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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