Statistical flag only — not an accusation of fraud
⚠️ This provider averages 1.1K services per working day — physically unusual for an individual practitioner
Based on 1.4M total services over 5 years (250 working days/year). Learn about impossible service volumes →
This provider's $16.2M in total Medicare payments ranks in the 99th percentile of Nurse Practitioner providers nationally.
Averaging 1.1K services per working day raises questions about billing patterns.
Medicare payments to this provider grew 625119% from 2015 to 2023.
100% 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 75/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 159686% in 2023
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 |
|---|---|---|---|---|---|---|---|
| 2015 | $43.71 | $33.67 | 1.30x | $10.04 | $2.6K | 77 | 3 |
| 2016 | $65.49 | $38.38 | 1.71x | $27.11 | $3.0K | 77 | 4 |
| 2017 | $57.19 | $31.74 | 1.80x | $25.45 | $1.4K | 45 | 2 |
| 2022 | $203.51 | $70.44 | 2.89x | $133.07 | $10.1K | 144 | 4 |
| 2023 | $23.88 | $11.77 | 2.03x | $12.11 | $16.2M | 1.4M | 5 |
| 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 | 1.4M | $16.2M | $11.76 | 2.03x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 168 | $12.8K | $76.00 | 2.83x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 174 | $8.1K | $46.79 | 4.37x |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 92 | $5.8K | $62.59 | 2.35x |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 70 | $2.4K | $34.33 | 13.28x |
| 90662 | Vaccine for influenza for injection into muscle | 58 | $2.3K | $38.86 | 1.12x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 13 | $1.4K | $108.77 | 2.78x |
| G0008 | Administration of influenza virus vaccine | 68 | $1.1K | $16.27 | 1.02x |
| 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 | 39 | $917.80 | $23.53 | 15.87x |
| 36415 | Insertion of needle into vein for collection of blood sample | 19 | $159.60 | $8.40 | 1.79x |
This provider submits charges 2.03 times higher than what Medicare actually pays.
A markup ratio of 2.03x means for every $100 Medicare pays, this provider initially charges $203. 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