Statistical flag only — not an accusation of fraud
This provider's $1.9M in total Medicare payments ranks in the 99th percentile of Obstetrics & Gynecology providers nationally.
Their average markup ratio of 6.87x is significantly above the specialty median of 3.1x.
Medicare payments to this provider grew 77% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 69/100. 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 | $155.19 | $22.59 | 6.87x | $132.60 | $136.3K | 6.0K | 51 |
| 2015 | $155.26 | $22.60 | 6.87x | $132.66 | $148.0K | 6.6K | 56 |
| 2016 | $155.19 | $22.59 | 6.87x | $132.60 | $159.7K | 7.1K | 60 |
| 2017 | $155.19 | $22.59 | 6.87x | $132.60 | $171.4K | 7.6K | 64 |
| 2018 | $155.19 | $22.59 | 6.87x | $132.60 | $183.1K | 8.1K | 69 |
| 2019 | $155.19 | $22.59 | 6.87x | $132.60 | $194.8K | 8.6K | 73 |
| 2020 | $155.26 | $22.60 | 6.87x | $132.66 | $206.5K | 9.1K | 78 |
| 2021 | $155.19 | $22.59 | 6.87x | $132.60 | $218.1K | 9.7K | 82 |
| 2022 | $155.19 | $22.59 | 6.87x | $132.60 | $229.8K | 10.2K | 86 |
| 2023 | $155.19 | $22.59 | 6.87x | $132.60 | $241.5K | 10.7K | 91 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office/outpatient visit, est patient, low | 29.4K | $665.0K | $22.59 | 5.96x |
| 99214 | Office/outpatient visit, est patient, moderate | 14.7K | $332.5K | $22.59 | 6.20x |
| 99215 | Office/outpatient visit, est patient, high | 9.8K | $221.7K | $22.59 | 8.06x |
| 99223 | Initial hospital care, high complexity | 7.4K | $166.2K | $22.59 | 6.15x |
| 99232 | Subsequent hospital care, moderate | 5.9K | $133.0K | $22.59 | 5.51x |
| 93000 | Electrocardiogram, complete | 4.9K | $110.8K | $22.59 | 8.24x |
| 71046 | Chest X-ray, 2 views | 4.2K | $95.0K | $22.60 | 6.96x |
| 80053 | Comprehensive metabolic panel | 3.7K | $83.1K | $22.59 | 6.17x |
| 85025 | Complete blood count (CBC) | 3.3K | $73.9K | $22.59 | 7.04x |
| 36415 | Venipuncture | 2.9K | $66.5K | $22.59 | 7.41x |
This provider submits charges 6.87 times higher than what Medicare actually pays.
A markup ratio of 6.87x means for every $100 Medicare pays, this provider initially charges $687. 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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