⚠️ This provider averages 514 services per working day — physically unusual for an individual practitioner
Based on 1.3M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $16.4M in total Medicare payments ranks in the 99th percentile of Gastroenterology providers nationally.
Averaging 514 services per working day raises questions about billing patterns.
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 | $142.62 | $27.94 | 5.10x | $114.68 | $1.3M | 95.3K | 67.2K |
| 2015 | $174.13 | $33.45 | 5.21x | $140.68 | $1.4M | 106.1K | 72.4K |
| 2016 | $161.00 | $29.17 | 5.52x | $131.83 | $1.6M | 119.2K | 82.3K |
| 2017 | $175.60 | $30.48 | 5.76x | $145.12 | $1.9M | 138.0K | 93.6K |
| 2018 | $163.74 | $27.59 | 5.93x | $136.15 | $2.0M | 140.7K | 98.0K |
| 2019 | $163.67 | $27.06 | 6.05x | $136.61 | $1.9M | 149.8K | 104.5K |
| 2020 | $153.13 | $24.28 | 6.31x | $128.85 | $1.7M | 139.6K | 99.2K |
| 2021 | $145.56 | $23.83 | 6.11x | $121.73 | $1.7M | 142.7K | 99.9K |
| 2022 | $166.42 | $26.16 | 6.36x | $140.26 | $1.5M | 124.9K | 86.8K |
| 2023 | $118.93 | $19.71 | 6.03x | $99.22 | $1.5M | 128.3K | 90.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 212.3K | $2.9M | $13.68 | 4.20x |
| 80053 | Blood test, comprehensive group of blood chemicals | 258.0K | $2.7M | $10.44 | 3.59x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 119.7K | $2.3M | $19.16 | 3.72x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 214.6K | $1.9M | $8.93 | 3.72x |
| 82306 | Vitamin D-3 level | 46.3K | $1.5M | $33.14 | 3.81x |
| 83036 | Hemoglobin A1C level | 97.7K | $1.1M | $11.08 | 3.72x |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | 18.9K | $402.3K | $21.31 | 2.49x |
| 82607 | Cyanocobalamin (vitamin B-12) level | 19.7K | $336.9K | $17.08 | 3.76x |
| 80048 | Blood test, basic group of blood chemicals | 36.1K | $301.6K | $8.35 | 3.56x |
| 82746 | Folic acid level | 14.5K | $240.8K | $16.64 | 3.74x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.7K | $217.5K | $37.86 | 4.07x |
| 84153 | PSA (prostate specific antigen) measurement | 8.3K | $182.9K | $22.00 | 3.55x |
| 82550 | Creatine kinase (cardiac enzyme) level | 29.1K | $177.1K | $6.08 | 4.64x |
| 84439 | Thyroxine (thyroid chemical) measurement | 17.0K | $174.5K | $10.26 | 3.72x |
| 84403 | Testosterone (hormone) level | 5.0K | $150.8K | $29.93 | 3.69x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 3.5K | $144.4K | $41.57 | 3.48x |
| 84436 | Thyroxine (thyroid chemical) measurement | 16.5K | $133.1K | $8.05 | 3.62x |
| 82728 | Ferritin (blood protein) level | 8.7K | $132.7K | $15.29 | 3.80x |
| 84550 | Uric acid level, blood | 25.2K | $110.4K | $4.37 | 4.37x |
| 80076 | Liver function blood test panel | 14.7K | $109.0K | $7.43 | 3.99x |
This provider submits charges 3.86 times higher than what Medicare actually pays.
A markup ratio of 3.86x means for every $100 Medicare pays, this provider initially charges $386. 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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