Statistical flag only — not an accusation of fraud
This provider's $438.0K in total Medicare payments ranks in the 98th percentile of Obstetrics & Gynecology providers nationally.
Their average markup ratio of 9.15x is significantly above the specialty median of 3.1x.
Medicare payments to this provider grew 65% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 75/100. 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 | $31.49 | $20.19 | 1.56x | $11.30 | $22.9K | 1.1K | 455 |
| 2015 | $54.34 | $20.19 | 2.69x | $34.15 | $31.5K | 1.6K | 624 |
| 2016 | $54.25 | $20.19 | 2.69x | $34.06 | $28.9K | 1.4K | 574 |
| 2017 | $72.44 | $20.18 | 3.59x | $52.26 | $32.7K | 1.6K | 648 |
| 2018 | $38.61 | $20.19 | 1.91x | $18.42 | $34.7K | 1.7K | 690 |
| 2019 | $43.28 | $20.18 | 2.14x | $23.10 | $36.8K | 1.8K | 729 |
| 2020 | $63.83 | $20.18 | 3.16x | $43.65 | $40.2K | 2.0K | 798 |
| 2021 | $74.32 | $20.18 | 3.68x | $54.14 | $42.0K | 2.1K | 834 |
| 2022 | $68.25 | $20.18 | 3.38x | $48.07 | $39.7K | 2.0K | 788 |
| 2023 | $52.00 | $20.19 | 2.58x | $31.81 | $37.8K | 1.9K | 749 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office visit, 30-39 min | 7.2K | $144.8K | $20.19 | 4.71x |
| 99213 | Established patient office visit, 20-29 min | 1.4K | $29.2K | $20.19 | 4.51x |
| 99215 | Established patient office visit, 40-54 min | 1.2K | $23.9K | $20.19 | 5.05x |
| 99232 | Subsequent hospital care, moderate complexity | 684 | $13.8K | $20.19 | 2.82x |
| 99223 | Initial hospital care, high complexity | 482 | $9.7K | $20.17 | 3.60x |
| G0463 | Hospital outpatient clinic visit | 754 | $15.2K | $20.20 | 3.36x |
| 99212 | Established patient office visit, 10-19 min | 363 | $7.3K | $20.17 | 3.22x |
| 93000 | Electrocardiogram, complete | 343 | $6.9K | $20.19 | 2.38x |
| 36415 | Venipuncture | 635 | $12.8K | $20.18 | 3.12x |
| 96372 | Therapeutic injection, subcutaneous or IM | 388 | $7.8K | $20.20 | 2.23x |
This provider submits charges 9.15 times higher than what Medicare actually pays.
A markup ratio of 9.15x means for every $100 Medicare pays, this provider initially charges $915. 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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