Our machine learning model analyzed billing patterns, service volumes, markup ratios, and peer comparisons to estimate a 90.1% probability that this provider's billing patterns are consistent with known fraud cases. This is ranked #346 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 $2.3M in total Medicare payments ranks in the 93th percentile of Hematology-Oncology providers nationally.
Medicare payments to this provider grew 125% 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 | 11.6K | $502.4K | $43.43 | 1.82x |
| 99214 | Office visit, established patient, moderate complexity | 10.4K | $452.2K | $43.44 | 1.98x |
| 99215 | Office visit, established patient, high complexity | 9.3K | $402.0K | $43.43 | 1.93x |
| 99232 | Subsequent hospital care, moderate complexity | 8.1K | $351.7K | $43.43 | 2.16x |
| 99233 | Subsequent hospital care, high complexity | 6.9K | $301.5K | $43.43 | 2.13x |
| 93000 | Electrocardiogram, complete | 5.8K | $251.2K | $43.43 | 1.79x |
| 71046 | Chest X-ray, 2 views | 4.6K | $201.0K | $43.44 | 1.99x |
| 80053 | Comprehensive metabolic panel | 3.5K | $150.7K | $43.44 | 1.65x |
| 85025 | Complete blood count with differential | 2.3K | $100.5K | $43.43 | 1.90x |
| 36415 | Venipuncture for blood draw | 1.2K | $50.2K | $43.43 | 1.79x |
This provider submits charges 2.01 times higher than what Medicare actually pays.
A markup ratio of 2.01x means for every $100 Medicare pays, this provider initially charges $201. 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 Hematology-Oncology providers in CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Luke Dreisbach, M.D. | Rancho Mirage, CA | $77.2M | ✓ Clear |
| Sachin Gupta, M.D. | Fresno, CA | $55.1M | ✓ Clear |
| Ravi Rao, MD | Fresno, CA | $49.1M | ⚠️ Flagged |
| Michael Sherman, M.D., PHD | Walnut Creek, CA | $38.9M | ✓ Clear |
| Nerses Tchekmedyian, M.D. | Irvine, CA | $38.0M | ✓ 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