Statistical flag only — not an accusation of fraud
This provider's $2.6M in total Medicare payments ranks in the 99th percentile of Oral Surgery (Dentist only) providers nationally.
Medicare payments to this provider grew 73% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 73/100. 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 | $1.2K | $332.24 | 3.56x | $851.27 | $157.5K | 474 | 274 |
| 2015 | $612.53 | $332.39 | 1.84x | $280.14 | $189.8K | 571 | 331 |
| 2016 | $1.1K | $331.92 | 3.37x | $787.47 | $171.6K | 517 | 299 |
| 2017 | $649.03 | $332.23 | 1.95x | $316.80 | $179.1K | 539 | 312 |
| 2018 | $1.1K | $332.30 | 3.41x | $800.46 | $214.3K | 645 | 374 |
| 2019 | $1.1K | $332.32 | 3.28x | $758.33 | $234.3K | 705 | 408 |
| 2020 | $1.3K | $332.16 | 3.78x | $922.55 | $260.1K | 783 | 453 |
| 2021 | $1.3K | $332.34 | 3.86x | $950.61 | $266.2K | 801 | 464 |
| 2022 | $987.36 | $332.23 | 2.97x | $655.13 | $248.8K | 749 | 434 |
| 2023 | $1.0K | $332.22 | 3.01x | $668.53 | $271.8K | 818 | 474 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office visit, 30-39 min | 1.6K | $542.5K | $332.23 | 2.01x |
| 99213 | Established patient office visit, 20-29 min | 539 | $179.2K | $332.44 | 3.58x |
| 99215 | Established patient office visit, 40-54 min | 307 | $102.0K | $332.16 | 1.65x |
| 99232 | Subsequent hospital care, moderate complexity | 225 | $74.9K | $332.81 | 4.94x |
| 99223 | Initial hospital care, high complexity | 552 | $183.2K | $331.87 | 5.52x |
| G0463 | Hospital outpatient clinic visit | 238 | $79.2K | $332.74 | 3.69x |
| 99212 | Established patient office visit, 10-19 min | 249 | $82.8K | $332.69 | 5.81x |
| 93000 | Electrocardiogram, complete | 234 | $77.6K | $331.62 | 3.07x |
| 36415 | Venipuncture | 232 | $77.1K | $332.35 | 1.59x |
| 96372 | Therapeutic injection, subcutaneous or IM | 355 | $117.9K | $332.06 | 4.22x |
This provider submits charges 3.41 times higher than what Medicare actually pays.
A markup ratio of 3.41x means for every $100 Medicare pays, this provider initially charges $341. 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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