Statistical flag only — not an accusation of fraud
This provider's $392.3K in total Medicare payments ranks in the 98th percentile of Obstetrics & Gynecology providers nationally.
Their average markup ratio of 6.61x 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 67/100. 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 | $303.53 | $45.92 | 6.61x | $257.61 | $27.5K | 598 | 244 |
| 2015 | $303.66 | $45.94 | 6.61x | $257.72 | $29.8K | 649 | 265 |
| 2016 | $303.73 | $45.95 | 6.61x | $257.78 | $32.2K | 700 | 286 |
| 2017 | $303.80 | $45.96 | 6.61x | $257.84 | $34.5K | 751 | 307 |
| 2018 | $303.53 | $45.92 | 6.61x | $257.61 | $36.9K | 803 | 328 |
| 2019 | $303.60 | $45.93 | 6.61x | $257.67 | $39.2K | 854 | 349 |
| 2020 | $303.66 | $45.94 | 6.61x | $257.72 | $41.6K | 905 | 370 |
| 2021 | $303.80 | $45.96 | 6.61x | $257.84 | $43.9K | 956 | 391 |
| 2022 | $303.86 | $45.97 | 6.61x | $257.89 | $46.3K | 1.0K | 412 |
| 2023 | $303.60 | $45.93 | 6.61x | $257.67 | $48.6K | 1.1K | 433 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office/outpatient visit, est patient, low | 2.9K | $133.9K | $45.94 | 6.54x |
| 99214 | Office/outpatient visit, est patient, moderate | 1.5K | $67.0K | $45.93 | 6.78x |
| 99215 | Office/outpatient visit, est patient, high | 972 | $44.6K | $45.93 | 7.72x |
| 99223 | Initial hospital care, high complexity | 729 | $33.5K | $45.93 | 5.48x |
| 99232 | Subsequent hospital care, moderate | 583 | $26.8K | $45.94 | 7.91x |
| 93000 | Electrocardiogram, complete | 486 | $22.3K | $45.93 | 7.28x |
| 71046 | Chest X-ray, 2 views | 416 | $19.1K | $45.99 | 5.88x |
| 80053 | Comprehensive metabolic panel | 364 | $16.7K | $45.99 | 6.60x |
| 85025 | Complete blood count (CBC) | 324 | $14.9K | $45.93 | 6.15x |
| 36415 | Venipuncture | 292 | $13.4K | $45.86 | 6.67x |
This provider submits charges 6.61 times higher than what Medicare actually pays.
A markup ratio of 6.61x means for every $100 Medicare pays, this provider initially charges $661. 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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