Our machine learning model analyzed billing patterns, service volumes, markup ratios, and peer comparisons to estimate a 94.3% probability that this provider's billing patterns are consistent with known fraud cases. This is ranked #3 out of 500 highest-risk providers analyzed. This is a statistical prediction, not a determination of fraud.
ML model prediction — not an accusation of fraud
This provider's $1.7M in total Medicare payments ranks in the 99th percentile of Anesthesiology providers nationally.
Medicare payments to this provider grew 133% from 2014 to 2023.
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 | $188.39 | $65.12 | 2.89x | $123.27 | $99.8K | 1.5K | 479 |
| 2015 | $188.33 | $65.10 | 2.89x | $123.23 | $116.4K | 1.8K | 558 |
| 2016 | $188.36 | $65.11 | 2.89x | $123.25 | $133.0K | 2.0K | 638 |
| 2017 | $188.33 | $65.10 | 2.89x | $123.23 | $149.7K | 2.3K | 718 |
| 2018 | $188.36 | $65.11 | 2.89x | $123.25 | $166.3K | 2.6K | 798 |
| 2019 | $188.36 | $65.11 | 2.89x | $123.25 | $166.3K | 2.6K | 798 |
| 2020 | $188.31 | $65.09 | 2.89x | $123.22 | $182.9K | 2.8K | 878 |
| 2021 | $188.33 | $65.10 | 2.89x | $123.23 | $199.5K | 3.1K | 957 |
| 2022 | $188.36 | $65.11 | 2.89x | $123.25 | $216.2K | 3.3K | 1.0K |
| 2023 | $188.33 | $65.10 | 2.89x | $123.23 | $232.8K | 3.6K | 1.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 00810 | Anesthesia for lower intestinal endoscopic procedures | 5.6K | $365.8K | $65.10 | 2.56x |
| 00100 | Anesthesia for salivary gland procedures | 4.6K | $299.3K | $65.11 | 2.65x |
| 01996 | Daily hospital management of epidural or subarachnoid drug administration | 3.6K | $232.8K | $65.10 | 2.75x |
| 00300 | Anesthesia for procedures on the head | 2.6K | $166.3K | $65.11 | 2.81x |
| 00400 | Anesthesia for integumentary system procedures on extremities | 2.0K | $133.0K | $65.11 | 2.65x |
| 00740 | Anesthesia for upper gastrointestinal endoscopic procedures | 1.8K | $116.4K | $65.10 | 2.49x |
| 01961 | Anesthesia for cardiac catheterization procedures | 1.5K | $99.8K | $65.12 | 2.85x |
| 00142 | Anesthesia for procedures on eye; lens surgery | 1.3K | $83.1K | $65.11 | 3.19x |
| 01630 | Anesthesia for open procedures on humeral head | 1.3K | $83.1K | $65.11 | 2.67x |
| 00920 | Anesthesia for procedures on male genitalia | 1.3K | $83.1K | $65.11 | 2.96x |
This provider submits charges 2.89 times higher than what Medicare actually pays.
A markup ratio of 2.89x means for every $100 Medicare pays, this provider initially charges $289. 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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