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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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Methodologyโ€ขDownload Data
  1. Home
  2. Providers
  3. Juan Bautista
๐Ÿฉบ
MDI

Juan Bautista, M.D.

NPI: 1164713194
Fresno, CA
10 years of data
General Practice
$353.7K
Total Payments
5.2K
Beneficiaries
10.4K
Services
31.06x
Markup Ratio

Peer Comparison

92th
percentile in specialty
This provider$353.7K
Specialty median$58.9K

๐Ÿ“‹ Key Findings

1Billed $353.7K over 10 years
231.06x markup ratio (above median)
3Risk score: 70 โ€” flagged for review
492th percentile in General Practice by payments
510 procedures with >3x markup

โš ๏ธ Flagged for Review

Risk Score: 70
  • 20x specialty median spending
  • Markup 31.1x (specialty median: 2.6x)
  • 34x specialty median beneficiaries
  • 37x specialty median services
View Deep Dives โ†’Report Fraud โ†’

Statistical flag only โ€” not an accusation of fraud

๐Ÿ”Ž Data Analysis

This provider's $353.7K in total Medicare payments ranks in the 92th percentile of General Practice providers nationally.

Their average markup ratio of 31.06x is significantly above the specialty median of 2.6x.

Medicare payments to this provider grew 77% from 2014 to 2023.

This provider has been statistically flagged with a risk score of 70/100. Statistical flags are not accusations of fraud.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

Submitted Charges vs. Medicare Payments

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

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$1.1K$34.0531.06x$1.0K$24.8K727374
2015$1.1K$34.0731.06x$1.0K$26.9K789406
2016$1.1K$34.0831.06x$1.0K$29.0K851438
2017$1.1K$34.0931.06x$1.0K$31.1K913470
2018$1.1K$34.0631.06x$1.0K$33.2K976502
2019$1.1K$34.0731.06x$1.0K$35.4K1.0K534
2020$1.1K$34.0831.06x$1.0K$37.5K1.1K566
2021$1.1K$34.0931.06x$1.0K$39.6K1.2K599
2022$1.1K$34.0731.06x$1.0K$41.7K1.2K631
2023$1.1K$34.0831.06x$1.0K$43.9K1.3K663

Top Procedures (10)

99213Office/outpatient visit, est patient, lowโš  36.6x markup
$120.7K
3.5K services$34.07/svc36.63x markup
99214Office/outpatient visit, est patient, moderateโš  28.5x markup
$60.4K
1.8K services$34.07/svc28.53x markup
99215Office/outpatient visit, est patient, highโš  26.0x markup
$40.2K
1.2K services$34.08/svc26.02x markup
99223Initial hospital care, high complexityโš  29.7x markup
$30.2K
886 services$34.07/svc29.71x markup
99232Subsequent hospital care, moderateโš  31.9x markup
$24.1K
709 services$34.06/svc31.91x markup
93000Electrocardiogram, completeโš  30.2x markup
$20.1K
591 services$34.05/svc30.16x markup
71046Chest X-ray, 2 viewsโš  28.6x markup
$17.2K
506 services$34.09/svc28.56x markup
80053Comprehensive metabolic panelโš  37.1x markup
$15.1K
443 services$34.07/svc37.14x markup
85025Complete blood count (CBC)โš  35.8x markup
$13.4K
394 services$34.05/svc35.83x markup
36415Venipunctureโš  25.8x markup
$12.1K
354 services$34.11/svc25.84x markup
Show detailed table โ–พ
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
99213Office/outpatient visit, est patient, low3.5K$120.7K$34.0736.63x
99214Office/outpatient visit, est patient, moderate1.8K$60.4K$34.0728.53x
99215Office/outpatient visit, est patient, high1.2K$40.2K$34.0826.02x
99223Initial hospital care, high complexity886$30.2K$34.0729.71x
99232Subsequent hospital care, moderate709$24.1K$34.0631.91x
93000Electrocardiogram, complete591$20.1K$34.0530.16x
71046Chest X-ray, 2 views506$17.2K$34.0928.56x
80053Comprehensive metabolic panel443$15.1K$34.0737.14x
85025Complete blood count (CBC)394$13.4K$34.0535.83x
36415Venipuncture354$12.1K$34.1125.84x

Markup Analysis

Charge-to-Payment Ratio

31.06x

This provider submits charges 31.06 times higher than what Medicare actually pays.

What This Means

A markup ratio of 31.06x means for every $100 Medicare pays, this provider initially charges $3106. This is higher than the national average.

Location

Fresno, CA

Provider Verification

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

Similar Providers

Other General Practice providers in CA for peer comparison.

Juan Bautista (you)
$353.7K
Jack Azad, M.D.โš ๏ธ
$34.5M
Show detailed table โ–พ
ProviderLocationTotal PaymentsStatus
Jack Azad, M.D.Los Angeles, CA$34.5Mโš ๏ธ Flagged

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Data Sources

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