Statistical flag only — not an accusation of fraud
This provider's $352.6K in total Medicare payments ranks in the 98th percentile of Obstetrics & Gynecology providers nationally.
Their average markup ratio of 12.4x 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 70/100. 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 | $557.50 | $44.96 | 12.40x | $512.54 | $24.7K | 549 | 115 |
| 2015 | $557.50 | $44.96 | 12.40x | $512.54 | $26.8K | 596 | 124 |
| 2016 | $557.63 | $44.97 | 12.40x | $512.66 | $28.9K | 643 | 134 |
| 2017 | $557.63 | $44.97 | 12.40x | $512.66 | $31.0K | 690 | 144 |
| 2018 | $557.63 | $44.97 | 12.40x | $512.66 | $33.1K | 737 | 154 |
| 2019 | $557.63 | $44.97 | 12.40x | $512.66 | $35.3K | 784 | 164 |
| 2020 | $557.75 | $44.98 | 12.40x | $512.77 | $37.4K | 831 | 174 |
| 2021 | $557.75 | $44.98 | 12.40x | $512.77 | $39.5K | 878 | 183 |
| 2022 | $557.75 | $44.98 | 12.40x | $512.77 | $41.6K | 925 | 193 |
| 2023 | $557.75 | $44.98 | 12.40x | $512.77 | $43.7K | 972 | 203 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office/outpatient visit, est patient, low | 2.7K | $120.4K | $44.97 | 13.28x |
| 99214 | Office/outpatient visit, est patient, moderate | 1.3K | $60.2K | $44.95 | 12.80x |
| 99215 | Office/outpatient visit, est patient, high | 892 | $40.1K | $44.99 | 11.50x |
| 99223 | Initial hospital care, high complexity | 669 | $30.1K | $44.99 | 11.41x |
| 99232 | Subsequent hospital care, moderate | 535 | $24.1K | $45.00 | 10.33x |
| 93000 | Electrocardiogram, complete | 446 | $20.1K | $44.99 | 12.81x |
| 71046 | Chest X-ray, 2 views | 382 | $17.2K | $45.02 | 12.78x |
| 80053 | Comprehensive metabolic panel | 335 | $15.0K | $44.92 | 13.49x |
| 85025 | Complete blood count (CBC) | 297 | $13.4K | $45.04 | 14.07x |
| 36415 | Venipuncture | 268 | $12.0K | $44.92 | 14.69x |
This provider submits charges 12.4 times higher than what Medicare actually pays.
A markup ratio of 12.4x means for every $100 Medicare pays, this provider initially charges $1240. 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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