Statistical flag only — not an accusation of fraud
This provider's $2.2M in total Medicare payments ranks in the 99th percentile of Obstetrics & Gynecology providers nationally.
Their average markup ratio of 7.34x is significantly above the specialty median of 3.1x.
Medicare payments to this provider grew 56% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 77/100. 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 | $84.92 | $23.63 | 3.59x | $61.29 | $142.4K | 6.0K | 197 |
| 2015 | $91.05 | $23.63 | 3.85x | $67.42 | $154.1K | 6.5K | 214 |
| 2016 | $92.39 | $23.64 | 3.91x | $68.75 | $133.9K | 5.7K | 186 |
| 2017 | $72.76 | $23.64 | 3.08x | $49.12 | $141.0K | 6.0K | 195 |
| 2018 | $49.58 | $23.63 | 2.10x | $25.95 | $149.7K | 6.3K | 207 |
| 2019 | $92.72 | $23.64 | 3.92x | $69.08 | $181.7K | 7.7K | 252 |
| 2020 | $72.01 | $23.64 | 3.05x | $48.37 | $173.4K | 7.3K | 240 |
| 2021 | $79.66 | $23.64 | 3.37x | $56.02 | $228.7K | 9.7K | 317 |
| 2022 | $57.33 | $23.63 | 2.43x | $33.70 | $207.9K | 8.8K | 288 |
| 2023 | $45.68 | $23.64 | 1.93x | $22.04 | $222.1K | 9.4K | 308 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office visit, 30-39 min | 31.1K | $735.6K | $23.64 | 2.80x |
| 99213 | Established patient office visit, 20-29 min | 3.9K | $91.9K | $23.64 | 5.20x |
| 99215 | Established patient office visit, 40-54 min | 5.1K | $120.3K | $23.64 | 4.74x |
| 99232 | Subsequent hospital care, moderate complexity | 5.0K | $117.1K | $23.63 | 2.41x |
| 99223 | Initial hospital care, high complexity | 3.7K | $88.1K | $23.63 | 4.55x |
| G0463 | Hospital outpatient clinic visit | 5.9K | $140.4K | $23.64 | 4.37x |
| 99212 | Established patient office visit, 10-19 min | 3.3K | $78.5K | $23.64 | 5.67x |
| 93000 | Electrocardiogram, complete | 4.2K | $99.4K | $23.64 | 3.19x |
| 36415 | Venipuncture | 3.4K | $79.6K | $23.63 | 4.75x |
| 96372 | Therapeutic injection, subcutaneous or IM | 3.4K | $79.4K | $23.64 | 2.48x |
This provider submits charges 7.34 times higher than what Medicare actually pays.
A markup ratio of 7.34x means for every $100 Medicare pays, this provider initially charges $734. 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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