Our machine learning model analyzed billing patterns, service volumes, markup ratios, and peer comparisons to estimate a 95.1% probability that this provider's billing patterns are consistent with known fraud cases. This is ranked #9 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 $1.2M in total Medicare payments ranks in the 97th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 133% from 2014 to 2023.
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 | $118.33 | $55.71 | 2.12x | $62.62 | $72.6K | 1.3K | 390 |
| 2015 | $118.35 | $55.72 | 2.12x | $62.63 | $84.8K | 1.5K | 455 |
| 2016 | $118.37 | $55.73 | 2.12x | $62.64 | $96.9K | 1.7K | 520 |
| 2017 | $118.39 | $55.74 | 2.12x | $62.65 | $109.0K | 2.0K | 585 |
| 2018 | $118.35 | $55.72 | 2.12x | $62.63 | $121.1K | 2.2K | 650 |
| 2019 | $118.35 | $55.72 | 2.12x | $62.63 | $121.1K | 2.2K | 650 |
| 2020 | $118.35 | $55.72 | 2.12x | $62.63 | $133.2K | 2.4K | 715 |
| 2021 | $118.37 | $55.73 | 2.12x | $62.64 | $145.3K | 2.6K | 780 |
| 2022 | $118.35 | $55.72 | 2.12x | $62.63 | $157.4K | 2.8K | 845 |
| 2023 | $118.35 | $55.72 | 2.12x | $62.63 | $169.5K | 3.0K | 910 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office visit, 30-39 minutes | 4.8K | $266.4K | $55.72 | 2.37x |
| 99213 | Established patient office visit, 20-29 minutes | 3.9K | $217.9K | $55.72 | 2.21x |
| 99215 | Established patient office visit, 40-54 minutes | 3.0K | $169.5K | $55.72 | 2.17x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 2.2K | $121.1K | $55.72 | 2.41x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.7K | $96.9K | $55.73 | 2.32x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.5K | $84.8K | $55.72 | 2.10x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 1.3K | $72.6K | $55.71 | 2.16x |
| 99291 | Critical care, first 30-74 minutes | 1.1K | $60.5K | $55.74 | 2.00x |
| G0463 | Hospital outpatient clinic visit | 1.1K | $60.5K | $55.74 | 1.93x |
| 99212 | Established patient office visit, 10-19 minutes | 1.1K | $60.5K | $55.74 | 2.41x |
This provider submits charges 2.12 times higher than what Medicare actually pays.
A markup ratio of 2.12x means for every $100 Medicare pays, this provider initially charges $212. 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.
Other Internal Medicine providers in FL for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Patrick Anastasio, D.O. | Fort Walton Beach, FL | $39.5M | ✓ Clear |
| Steven Newman, MD | Naples, FL | $35.4M | ⚠️ Flagged |
| Abraham Schwarzberg, MD | Palm Springs, FL | $34.6M | ✓ Clear |
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data