Statistical flag only — not an accusation of fraud
This provider's $251.8K in total Medicare payments ranks in the 97th percentile of Obstetrics & Gynecology providers nationally.
Their average markup ratio of 11.89x is significantly above the specialty median of 3.1x.
Medicare payments to this provider grew 77% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 69/100. 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 | $371.56 | $31.25 | 11.89x | $340.31 | $17.6K | 564 | 147 |
| 2015 | $371.80 | $31.27 | 11.89x | $340.53 | $19.1K | 612 | 160 |
| 2016 | $371.92 | $31.28 | 11.89x | $340.64 | $20.6K | 660 | 172 |
| 2017 | $372.04 | $31.29 | 11.89x | $340.75 | $22.2K | 708 | 185 |
| 2018 | $371.68 | $31.26 | 11.89x | $340.42 | $23.7K | 757 | 197 |
| 2019 | $371.92 | $31.28 | 11.89x | $340.64 | $25.2K | 805 | 210 |
| 2020 | $372.04 | $31.29 | 11.89x | $340.75 | $26.7K | 853 | 223 |
| 2021 | $371.68 | $31.26 | 11.89x | $340.42 | $28.2K | 902 | 235 |
| 2022 | $371.80 | $31.27 | 11.89x | $340.53 | $29.7K | 950 | 248 |
| 2023 | $371.92 | $31.28 | 11.89x | $340.64 | $31.2K | 998 | 261 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office/outpatient visit, est patient, low | 2.7K | $86.0K | $31.27 | 11.53x |
| 99214 | Office/outpatient visit, est patient, moderate | 1.4K | $43.0K | $31.28 | 11.18x |
| 99215 | Office/outpatient visit, est patient, high | 916 | $28.7K | $31.28 | 14.12x |
| 99223 | Initial hospital care, high complexity | 687 | $21.5K | $31.28 | 9.61x |
| 99232 | Subsequent hospital care, moderate | 550 | $17.2K | $31.26 | 12.94x |
| 93000 | Electrocardiogram, complete | 458 | $14.3K | $31.28 | 12.68x |
| 71046 | Chest X-ray, 2 views | 393 | $12.3K | $31.25 | 12.33x |
| 80053 | Comprehensive metabolic panel | 344 | $10.7K | $31.23 | 9.61x |
| 85025 | Complete blood count (CBC) | 305 | $9.6K | $31.31 | 9.63x |
| 36415 | Venipuncture | 275 | $8.6K | $31.26 | 13.62x |
This provider submits charges 11.89 times higher than what Medicare actually pays.
A markup ratio of 11.89x means for every $100 Medicare pays, this provider initially charges $1189. 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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