Our machine learning model analyzed billing patterns, service volumes, markup ratios, and peer comparisons to estimate a 87.8% probability that this provider's billing patterns are consistent with known fraud cases. This is ranked #275 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 $1.4M in total Medicare payments ranks in the 97th percentile of Podiatry providers nationally.
Medicare payments to this provider grew 118% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office visit, established patient, low complexity | 5.4K | $298.6K | $54.97 | 2.01x |
| 99214 | Office visit, established patient, moderate complexity | 4.9K | $268.7K | $54.97 | 2.13x |
| 99215 | Office visit, established patient, high complexity | 4.3K | $238.8K | $54.97 | 2.24x |
| 99232 | Subsequent hospital care, moderate complexity | 3.8K | $209.0K | $54.97 | 1.67x |
| 99233 | Subsequent hospital care, high complexity | 3.3K | $179.1K | $54.97 | 2.18x |
| 93000 | Electrocardiogram, complete | 2.7K | $149.3K | $54.96 | 1.65x |
| 71046 | Chest X-ray, 2 views | 2.2K | $119.4K | $54.98 | 2.02x |
| 80053 | Comprehensive metabolic panel | 1.6K | $89.6K | $54.98 | 1.83x |
| 85025 | Complete blood count with differential | 1.1K | $59.7K | $54.98 | 2.40x |
| 36415 | Venipuncture for blood draw | 543 | $29.9K | $54.98 | 2.22x |
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.
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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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