Statistical flag only — not an accusation of fraud
This provider's $144.6K in total Medicare payments ranks in the 95th percentile of Obstetrics & Gynecology providers nationally.
Their average markup ratio of 23.2x 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 | $935.66 | $40.33 | 23.20x | $895.33 | $10.1K | 251 | 91 |
| 2015 | $937.51 | $40.41 | 23.20x | $897.10 | $11.0K | 272 | 98 |
| 2016 | $935.89 | $40.34 | 23.20x | $895.55 | $11.9K | 294 | 106 |
| 2017 | $937.28 | $40.40 | 23.20x | $896.88 | $12.7K | 315 | 114 |
| 2018 | $935.89 | $40.34 | 23.20x | $895.55 | $13.6K | 337 | 122 |
| 2019 | $937.28 | $40.40 | 23.20x | $896.88 | $14.5K | 358 | 129 |
| 2020 | $935.89 | $40.34 | 23.20x | $895.55 | $15.3K | 380 | 137 |
| 2021 | $937.05 | $40.39 | 23.20x | $896.66 | $16.2K | 401 | 145 |
| 2022 | $935.89 | $40.34 | 23.20x | $895.55 | $17.1K | 423 | 153 |
| 2023 | $937.05 | $40.39 | 23.20x | $896.66 | $17.9K | 444 | 160 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office/outpatient visit, est patient, low | 1.2K | $49.4K | $40.37 | 26.57x |
| 99214 | Office/outpatient visit, est patient, moderate | 612 | $24.7K | $40.34 | 18.86x |
| 99215 | Office/outpatient visit, est patient, high | 408 | $16.5K | $40.34 | 19.95x |
| 99223 | Initial hospital care, high complexity | 306 | $12.3K | $40.34 | 19.39x |
| 99232 | Subsequent hospital care, moderate | 245 | $9.9K | $40.31 | 25.48x |
| 93000 | Electrocardiogram, complete | 204 | $8.2K | $40.34 | 23.70x |
| 71046 | Chest X-ray, 2 views | 175 | $7.1K | $40.31 | 27.55x |
| 80053 | Comprehensive metabolic panel | 153 | $6.2K | $40.34 | 25.73x |
| 85025 | Complete blood count (CBC) | 136 | $5.5K | $40.34 | 23.87x |
| 36415 | Venipuncture | 122 | $4.9K | $40.47 | 21.30x |
This provider submits charges 23.2 times higher than what Medicare actually pays.
A markup ratio of 23.2x means for every $100 Medicare pays, this provider initially charges $2320. 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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