Statistical flag only — not an accusation of fraud
⚠️ This provider averages 891 services per working day — physically unusual for an individual practitioner
Based on 1.1M total services over 5 years (250 working days/year). Learn about impossible service volumes →
This provider's $13.2M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Averaging 891 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 34626% from 2019 to 2023.
99% of their billing comes from a single procedure code (K1034 — Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count).
This provider has been statistically flagged with a risk score of 67/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 16248% in 2022
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 |
|---|---|---|---|---|---|---|---|
| 2019 | $227.90 | $64.25 | 3.55x | $163.65 | $27.6K | 429 | 5 |
| 2020 | $235.12 | $74.24 | 3.17x | $160.88 | $48.1K | 648 | 8 |
| 2021 | $239.31 | $67.58 | 3.54x | $171.73 | $21.5K | 318 | 5 |
| 2022 | $12.00 | $11.76 | 1.02x | $0.24 | $3.5M | 298.8K | 1 |
| 2023 | $12.00 | $11.76 | 1.02x | $0.24 | $9.6M | 814.0K | 1 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 1.1M | $13.1M | $11.76 | 1.02x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 627 | $38.0K | $60.65 | 3.43x |
| 99239 | Hospital discharge day management, more than 30 minutes | 253 | $22.7K | $89.57 | 3.31x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 222 | $19.4K | $87.27 | 3.29x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 129 | $4.2K | $32.63 | 3.35x |
| 99238 | Hospital discharge day management, 30 minutes or less | 56 | $3.5K | $61.80 | 3.52x |
| 99217 | Hospital observation care on day of discharge | 53 | $3.1K | $58.00 | 3.45x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 15 | $2.4K | $162.23 | 3.22x |
| 99220 | Hospital observation care, typically 70 minutes | 13 | $2.2K | $167.60 | 2.99x |
| 99225 | Subsequent observation care, typically 25 minutes per day | 27 | $1.7K | $64.45 | 3.28x |
This provider submits charges 1.04 times higher than what Medicare actually pays.
A markup ratio of 1.04x means for every $100 Medicare pays, this provider initially charges $104. This is lower 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.
Other Internal Medicine providers in CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Aaron Jeng, MD, MPH | San Gabriel, CA | $45.6M | ✓ Clear |
| Richard Park, M.D. | Granada Hills, CA | $34.7M | ⚠️ Flagged |
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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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