Statistical flag only — not an accusation of fraud
This provider averages 71 services per working day
Based on 177.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $2.1M in total Medicare payments ranks in the 98th percentile of Pharmacy providers nationally.
Averaging 71 services per working day raises questions about billing patterns.
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 | $18.04 | $11.77 | 1.53x | $6.27 | $143.6K | 12.2K | 846 |
| 2015 | $32.62 | $11.77 | 2.77x | $20.85 | $133.8K | 11.4K | 788 |
| 2016 | $43.43 | $11.77 | 3.69x | $31.66 | $162.6K | 13.8K | 958 |
| 2017 | $42.26 | $11.77 | 3.59x | $30.49 | $141.1K | 12.0K | 831 |
| 2018 | $43.13 | $11.77 | 3.66x | $31.36 | $149.3K | 12.7K | 880 |
| 2019 | $22.57 | $11.77 | 1.92x | $10.80 | $189.2K | 16.1K | 1.1K |
| 2020 | $20.52 | $11.77 | 1.74x | $8.75 | $166.3K | 14.1K | 980 |
| 2021 | $27.34 | $11.77 | 2.32x | $15.57 | $204.8K | 17.4K | 1.2K |
| 2022 | $27.05 | $11.77 | 2.30x | $15.28 | $188.8K | 16.0K | 1.1K |
| 2023 | $37.29 | $11.77 | 3.17x | $25.52 | $197.7K | 16.8K | 1.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office visit, 30-39 min | 43.4K | $511.0K | $11.77 | 2.71x |
| 99213 | Established patient office visit, 20-29 min | 15.7K | $184.9K | $11.77 | 5.57x |
| 99215 | Established patient office visit, 40-54 min | 12.0K | $141.2K | $11.77 | 2.48x |
| 99232 | Subsequent hospital care, moderate complexity | 5.7K | $66.8K | $11.77 | 3.75x |
| 99223 | Initial hospital care, high complexity | 4.3K | $50.9K | $11.77 | 3.61x |
| G0463 | Hospital outpatient clinic visit | 9.3K | $109.1K | $11.77 | 5.75x |
| 99212 | Established patient office visit, 10-19 min | 10.4K | $122.8K | $11.77 | 5.37x |
| 93000 | Electrocardiogram, complete | 9.6K | $112.6K | $11.77 | 3.70x |
| 36415 | Venipuncture | 5.8K | $68.6K | $11.78 | 4.95x |
| 96372 | Therapeutic injection, subcutaneous or IM | 3.4K | $40.4K | $11.78 | 5.14x |
This provider submits charges 3.63 times higher than what Medicare actually pays.
A markup ratio of 3.63x means for every $100 Medicare pays, this provider initially charges $363. This is higher 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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