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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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ยฉ 2026 OpenMedicare. Independent data journalism. Built by TheDataProject.ai

Methodologyโ€ขDownload Data
  1. Home
  2. Providers
  3. Gilbert Dominguez
๐Ÿฉบ
MDIndividual

Gilbert Dominguez, M.D.

NPI: 1275601478
La Jolla, CA
10 years of data
General Practice
$599.2K
Total Payments
5.4K
Beneficiaries
13.0K
Services
34.98x
Markup Ratio

Peer Comparison

95th
percentile in specialty
This provider$599.2K
Specialty median$58.9K

๐Ÿ“‹ Key Findings

1Billed $599.2K over 10 years
234.98x markup ratio (above median)
3Risk score: 75 โ€” flagged for review
495th percentile in General Practice by payments
57 procedures with >3x markup

โš ๏ธ Flagged for Review

Risk Score: 75
  • 33x specialty median spending
  • Markup 35.0x (specialty median: 2.6x)
  • 45x specialty median beneficiaries
  • 46x 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 $599.2K in total Medicare payments ranks in the 95th percentile of General Practice providers nationally.

Their average markup ratio of 34.98x is significantly above the specialty median of 2.6x.

Medicare payments to this provider grew 72% from 2014 to 2023.

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.

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$90.11$46.091.96x$44.02$31.9K692371
2015$174.71$46.073.79x$128.64$41.1K893479
2016$93.33$46.092.02x$47.24$47.0K1.0K546
2017$118.06$46.072.56x$71.99$42.0K912489
2018$184.03$46.093.99x$137.94$40.8K886475
2019$104.48$46.102.27x$58.38$46.8K1.0K545
2020$80.41$46.091.74x$34.32$44.4K963516
2021$117.27$46.092.54x$71.18$57.5K1.2K669
2022$131.99$46.092.86x$85.90$55.9K1.2K650
2023$109.41$46.092.37x$63.32$54.9K1.2K639

Top Procedures (10)

99214Established patient office visit, 30-39 minโš  3.4x markup
$170.6K
3.7K services$46.08/svc3.38x markup
99213Established patient office visit, 20-29 min
$14.7K
319 services$46.16/svc1.86x markup
99215Established patient office visit, 40-54 minโš  4.5x markup
$36.5K
791 services$46.11/svc4.50x markup
99232Subsequent hospital care, moderate complexity
$36.5K
791 services$46.10/svc2.59x markup
99223Initial hospital care, high complexity
$42.6K
925 services$46.08/svc2.82x markup
G0463Hospital outpatient clinic visitโš  4.7x markup
$21.9K
476 services$46.04/svc4.69x markup
99212Established patient office visit, 10-19 minโš  4.4x markup
$23.1K
500 services$46.12/svc4.40x markup
93000Electrocardiogram, completeโš  3.6x markup
$21.8K
473 services$46.12/svc3.56x markup
36415Venipunctureโš  5.0x markup
$21.7K
471 services$46.09/svc5.01x markup
96372Therapeutic injection, subcutaneous or IMโš  3.7x markup
$6.7K
145 services$45.94/svc3.66x markup
Show detailed table โ–พ
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
99214Established patient office visit, 30-39 min3.7K$170.6K$46.083.38x
99213Established patient office visit, 20-29 min319$14.7K$46.161.86x
99215Established patient office visit, 40-54 min791$36.5K$46.114.50x
99232Subsequent hospital care, moderate complexity791$36.5K$46.102.59x
99223Initial hospital care, high complexity925$42.6K$46.082.82x
G0463Hospital outpatient clinic visit476$21.9K$46.044.69x
99212Established patient office visit, 10-19 min500$23.1K$46.124.40x
93000Electrocardiogram, complete473$21.8K$46.123.56x
36415Venipuncture471$21.7K$46.095.01x
96372Therapeutic injection, subcutaneous or IM145$6.7K$45.943.66x

Markup Analysis

Charge-to-Payment Ratio

34.98x

This provider submits charges 34.98 times higher than what Medicare actually pays.

What This Means

A markup ratio of 34.98x means for every $100 Medicare pays, this provider initially charges $3498. This is higher than the national average.

Location

La Jolla, 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.

Gilbert Dominguez (you)
$599.2K
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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