Our machine learning model analyzed billing patterns, service volumes, markup ratios, and peer comparisons to estimate a 94.7% probability that this provider's billing patterns are consistent with known fraud cases. This is ranked #10 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 $795.8K in total Medicare payments ranks in the 97th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 133% from 2014 to 2023.
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 | $82.76 | $42.79 | 1.93x | $39.97 | $47.8K | 1.1K | 423 |
| 2015 | $82.68 | $42.75 | 1.93x | $39.93 | $55.7K | 1.3K | 494 |
| 2016 | $82.70 | $42.76 | 1.93x | $39.94 | $63.7K | 1.5K | 565 |
| 2017 | $82.70 | $42.76 | 1.93x | $39.94 | $71.6K | 1.7K | 635 |
| 2018 | $82.70 | $42.76 | 1.93x | $39.94 | $79.6K | 1.9K | 706 |
| 2019 | $82.70 | $42.76 | 1.93x | $39.94 | $79.6K | 1.9K | 706 |
| 2020 | $82.72 | $42.77 | 1.93x | $39.95 | $87.5K | 2.0K | 776 |
| 2021 | $82.72 | $42.77 | 1.93x | $39.95 | $95.5K | 2.2K | 847 |
| 2022 | $82.72 | $42.77 | 1.93x | $39.95 | $103.5K | 2.4K | 917 |
| 2023 | $82.72 | $42.77 | 1.93x | $39.95 | $111.4K | 2.6K | 988 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office visit, 30-39 minutes | 4.1K | $175.1K | $42.77 | 1.99x |
| 99213 | Established patient office visit, 20-29 minutes | 3.3K | $143.3K | $42.77 | 2.06x |
| 99215 | Established patient office visit, 40-54 minutes | 2.6K | $111.4K | $42.77 | 1.72x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.9K | $79.6K | $42.76 | 2.10x |
| G0463 | Hospital outpatient clinic visit | 1.5K | $63.7K | $42.76 | 2.15x |
| 99212 | Established patient office visit, 10-19 minutes | 1.3K | $55.7K | $42.75 | 1.90x |
| 90715 | Tdap vaccine | 1.1K | $47.8K | $42.79 | 1.76x |
| 99395 | Preventive visit, established patient, 18-39 years | 930 | $39.8K | $42.79 | 2.10x |
| 99396 | Preventive visit, established patient, 40-64 years | 930 | $39.8K | $42.79 | 1.68x |
| 36415 | Collection of venous blood by venipuncture | 930 | $39.8K | $42.79 | 2.18x |
This provider submits charges 1.93 times higher than what Medicare actually pays.
A markup ratio of 1.93x means for every $100 Medicare pays, this provider initially charges $193. 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 Family Practice providers in GA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Kristi Hunter, M.D. | Sylvania, GA | $38.3M | ✓ 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