Statistical flag only — not an accusation of fraud
This provider's $562.1K in total Medicare payments ranks in the 99th percentile of Obstetrics & Gynecology providers nationally.
Their average markup ratio of 21.99x is significantly above the specialty median of 3.1x.
Medicare payments to this provider grew 68% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 78/100. 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 | $49.69 | $15.60 | 3.19x | $34.09 | $33.3K | 2.1K | 68 |
| 2015 | $58.66 | $15.60 | 3.76x | $43.06 | $34.5K | 2.2K | 70 |
| 2016 | $62.15 | $15.60 | 3.98x | $46.55 | $40.3K | 2.6K | 82 |
| 2017 | $51.81 | $15.60 | 3.32x | $36.21 | $42.7K | 2.7K | 87 |
| 2018 | $60.35 | $15.60 | 3.87x | $44.75 | $39.3K | 2.5K | 80 |
| 2019 | $26.42 | $15.59 | 1.69x | $10.83 | $52.2K | 3.3K | 106 |
| 2020 | $57.43 | $15.60 | 3.68x | $41.83 | $50.9K | 3.3K | 103 |
| 2021 | $31.07 | $15.60 | 1.99x | $15.47 | $50.3K | 3.2K | 102 |
| 2022 | $27.94 | $15.60 | 1.79x | $12.34 | $56.1K | 3.6K | 114 |
| 2023 | $32.51 | $15.60 | 2.08x | $16.91 | $55.9K | 3.6K | 114 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office visit, 30-39 min | 12.2K | $190.1K | $15.60 | 1.95x |
| 99213 | Established patient office visit, 20-29 min | 1.3K | $20.0K | $15.60 | 3.35x |
| 99215 | Established patient office visit, 40-54 min | 2.2K | $35.1K | $15.60 | 3.35x |
| 99232 | Subsequent hospital care, moderate complexity | 1.6K | $25.1K | $15.60 | 5.32x |
| 99223 | Initial hospital care, high complexity | 1.3K | $19.7K | $15.60 | 4.78x |
| G0463 | Hospital outpatient clinic visit | 1.5K | $23.8K | $15.60 | 3.95x |
| 99212 | Established patient office visit, 10-19 min | 1.6K | $25.4K | $15.60 | 5.17x |
| 93000 | Electrocardiogram, complete | 931 | $14.5K | $15.59 | 1.70x |
| 36415 | Venipuncture | 1.4K | $22.4K | $15.60 | 2.04x |
| 96372 | Therapeutic injection, subcutaneous or IM | 697 | $10.9K | $15.60 | 3.60x |
This provider submits charges 21.99 times higher than what Medicare actually pays.
A markup ratio of 21.99x means for every $100 Medicare pays, this provider initially charges $2199. 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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