Statistical flag only — not an accusation of fraud
This provider's $313.6K in total Medicare payments ranks in the 98th percentile of Obstetrics & Gynecology providers nationally.
Their average markup ratio of 10.62x 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 71/100. 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 | $425.44 | $40.06 | 10.62x | $385.38 | $22.0K | 548 | 211 |
| 2015 | $425.33 | $40.05 | 10.62x | $385.28 | $23.8K | 595 | 229 |
| 2016 | $425.33 | $40.05 | 10.62x | $385.28 | $25.7K | 642 | 247 |
| 2017 | $425.33 | $40.05 | 10.62x | $385.28 | $27.6K | 689 | 265 |
| 2018 | $425.33 | $40.05 | 10.62x | $385.28 | $29.5K | 736 | 283 |
| 2019 | $425.33 | $40.05 | 10.62x | $385.28 | $31.4K | 783 | 301 |
| 2020 | $425.33 | $40.05 | 10.62x | $385.28 | $33.2K | 830 | 319 |
| 2021 | $425.33 | $40.05 | 10.62x | $385.28 | $35.1K | 877 | 337 |
| 2022 | $425.33 | $40.05 | 10.62x | $385.28 | $37.0K | 924 | 355 |
| 2023 | $425.33 | $40.05 | 10.62x | $385.28 | $38.9K | 971 | 373 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office/outpatient visit, est patient, low | 2.7K | $107.1K | $40.05 | 10.08x |
| 99214 | Office/outpatient visit, est patient, moderate | 1.3K | $53.5K | $40.04 | 11.47x |
| 99215 | Office/outpatient visit, est patient, high | 891 | $35.7K | $40.05 | 9.34x |
| 99223 | Initial hospital care, high complexity | 668 | $26.8K | $40.07 | 8.53x |
| 99232 | Subsequent hospital care, moderate | 535 | $21.4K | $40.02 | 12.21x |
| 93000 | Electrocardiogram, complete | 446 | $17.8K | $40.01 | 9.46x |
| 71046 | Chest X-ray, 2 views | 382 | $15.3K | $40.04 | 11.45x |
| 80053 | Comprehensive metabolic panel | 334 | $13.4K | $40.07 | 9.02x |
| 85025 | Complete blood count (CBC) | 297 | $11.9K | $40.05 | 11.28x |
| 36415 | Venipuncture | 267 | $10.7K | $40.10 | 9.60x |
This provider submits charges 10.62 times higher than what Medicare actually pays.
A markup ratio of 10.62x means for every $100 Medicare pays, this provider initially charges $1062. 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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