Statistical flag only — not an accusation of fraud
⚠️ This provider averages 714 services per working day — physically unusual for an individual practitioner
Based on 1.1M total services over 6 years (250 working days/year). Learn about impossible service volumes →
This provider's $53.4M in total Medicare payments ranks in the 99th percentile of Geriatric Medicine providers nationally.
Averaging 714 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 36019% from 2018 to 2023.
This provider has been statistically flagged with a risk score of 75/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1293% 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 |
|---|---|---|---|---|---|---|---|
| 2018 | $218.04 | $82.73 | 2.64x | $135.31 | $115.6K | 1.4K | 15 |
| 2019 | $154.32 | $73.16 | 2.11x | $81.16 | $168.7K | 2.3K | 14 |
| 2020 | $195.60 | $68.39 | 2.86x | $127.21 | $58.7K | 859 | 12 |
| 2021 | $113.10 | $41.45 | 2.73x | $71.65 | $757.7K | 18.3K | 15 |
| 2022 | $94.92 | $52.74 | 1.80x | $42.18 | $10.6M | 200.2K | 12 |
| 2023 | $121.90 | $49.26 | 2.47x | $72.64 | $41.7M | 847.4K | 10 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 541.2K | $30.4M | $56.22 | 2.28x |
| 99439 | Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month | 429.2K | $18.4M | $42.78 | 2.39x |
| 99457 | Management using the results of remote vital sign monitoring per calendar month, first 20 minutes | 53.4K | $2.3M | $43.66 | 2.55x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 33.9K | $1.7M | $50.40 | 2.65x |
| 99453 | Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment | 7.2K | $127.2K | $17.77 | 2.71x |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 1.6K | $110.6K | $69.62 | 2.31x |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | 745 | $77.6K | $104.16 | 2.82x |
| G0407 | Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth | 882 | $52.5K | $59.54 | 2.54x |
| G0408 | Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth | 448 | $38.5K | $86.03 | 2.45x |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 304 | $34.1K | $112.23 | 2.13x |
| G0426 | Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth | 304 | $34.1K | $112.05 | 2.59x |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 170 | $22.3K | $131.45 | 2.29x |
| G0427 | Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth | 115 | $19.2K | $166.88 | 2.65x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 374 | $19.2K | $51.27 | 1.85x |
| G0425 | Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth | 172 | $14.4K | $83.88 | 2.52x |
| 99497 | Advance care planning, first 30 minutes | 152 | $9.3K | $61.39 | 2.66x |
| G0406 | Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth | 187 | $5.9K | $31.58 | 2.86x |
| 99318 | Nursing facility annual assessment, typically 30 minutes | 47 | $3.6K | $77.09 | 2.91x |
| 90791 | Psychiatric diagnostic evaluation | 16 | $1.6K | $98.00 | 1.72x |
| 99356 | Prolonged inpatient or observation hospital service, first hour | 13 | $992.55 | $76.35 | 2.59x |
This provider submits charges 2.34 times higher than what Medicare actually pays.
A markup ratio of 2.34x means for every $100 Medicare pays, this provider initially charges $234. 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.
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