Our machine learning model analyzed billing patterns, service volumes, markup ratios, and peer comparisons to estimate a 90.0% probability that this provider's billing patterns are consistent with known fraud cases. This is ranked #246 out of 500 highest-risk providers analyzed. This is a statistical prediction, not a determination of fraud.
ML model prediction — not an accusation of fraud
This provider's $772.8K in total Medicare payments ranks in the 78th percentile of Hematology-Oncology providers nationally.
Medicare payments to this provider grew 133% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office visit, established patient, low complexity | 4.0K | $169.9K | $42.60 | 3.13x |
| 99214 | Office visit, established patient, moderate complexity | 3.6K | $152.9K | $42.59 | 3.14x |
| 99215 | Office visit, established patient, high complexity | 3.2K | $135.9K | $42.59 | 3.32x |
| 99232 | Subsequent hospital care, moderate complexity | 2.8K | $118.9K | $42.59 | 3.59x |
| 99233 | Subsequent hospital care, high complexity | 2.4K | $101.9K | $42.60 | 3.48x |
| 93000 | Electrocardiogram, complete | 2.0K | $84.9K | $42.60 | 3.70x |
| 71046 | Chest X-ray, 2 views | 1.6K | $68.0K | $42.61 | 3.21x |
| 80053 | Comprehensive metabolic panel | 1.2K | $51.0K | $42.58 | 3.73x |
| 85025 | Complete blood count with differential | 798 | $34.0K | $42.58 | 3.36x |
| 36415 | Venipuncture for blood draw | 399 | $17.0K | $42.58 | 3.40x |
This provider submits charges 3.23 times higher than what Medicare actually pays.
A markup ratio of 3.23x means for every $100 Medicare pays, this provider initially charges $323. 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.
Other Hematology-Oncology providers in IL for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Pramern Sriratana, M.D. | Normal, IL | $33.5M | ✓ Clear |
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data