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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Providers
  3. Andrea Pezzella
⚕️
MDI

Andrea Pezzella, MD

NPI: 1730157058
West Columbia, SC
10 years of data
Obstetrics & Gynecology
$372.1K
Total Payments
2.7K
Beneficiaries
14.2K
Services
8.03x
Markup Ratio

Peer Comparison

98th
percentile in specialty
This provider$372.1K
Specialty median$14.0K

📋 Key Findings

1Billed $372.1K over 10 years
28.03x markup ratio (above median)
3Risk score: 68 — flagged for review
498th percentile in Obstetrics & Gynecology by payments
510 procedures with >3x markup

⚠️ Flagged for Review

Risk Score: 68
  • 79x specialty median spending
  • Markup 8.0x (specialty median: 3.1x)
  • 37x specialty median beneficiaries
  • 165x specialty median services
View Deep Dives →Report Fraud →

Statistical flag only — not an accusation of fraud

🔎 Data Analysis

This provider's $372.1K in total Medicare payments ranks in the 98th percentile of Obstetrics & Gynecology providers nationally.

Their average markup ratio of 8.03x 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 68/100. Statistical flags are not accusations of fraud.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$209.98$26.158.03x$183.83$26.0K996194
2015$210.06$26.168.03x$183.90$28.3K1.1K211
2016$210.15$26.178.03x$183.98$30.5K1.2K227
2017$209.98$26.158.03x$183.83$32.7K1.3K244
2018$210.06$26.168.03x$183.90$35.0K1.3K260
2019$209.98$26.158.03x$183.83$37.2K1.4K277
2020$209.98$26.158.03x$183.83$39.4K1.5K294
2021$210.06$26.168.03x$183.90$41.7K1.6K310
2022$209.98$26.158.03x$183.83$43.9K1.7K327
2023$210.06$26.168.03x$183.90$46.1K1.8K343

Top Procedures (10)

99213Office/outpatient visit, est patient, low⚠ 7.0x markup
$127.0K
4.9K services$26.15/svc6.99x markup
99214Office/outpatient visit, est patient, moderate⚠ 8.7x markup
$63.5K
2.4K services$26.16/svc8.66x markup
99215Office/outpatient visit, est patient, high⚠ 8.0x markup
$42.3K
1.6K services$26.15/svc8.02x markup
99223Initial hospital care, high complexity⚠ 9.2x markup
$31.8K
1.2K services$26.16/svc9.15x markup
99232Subsequent hospital care, moderate⚠ 6.5x markup
$25.4K
971 services$26.17/svc6.47x markup
93000Electrocardiogram, complete⚠ 9.2x markup
$21.2K
809 services$26.17/svc9.24x markup
71046Chest X-ray, 2 views⚠ 6.6x markup
$18.1K
694 services$26.15/svc6.59x markup
80053Comprehensive metabolic panel⚠ 8.6x markup
$15.9K
607 services$26.16/svc8.56x markup
85025Complete blood count (CBC)⚠ 9.3x markup
$14.1K
540 services$26.14/svc9.27x markup
36415Venipuncture⚠ 7.8x markup
$12.7K
486 services$26.14/svc7.76x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
99213Office/outpatient visit, est patient, low4.9K$127.0K$26.156.99x
99214Office/outpatient visit, est patient, moderate2.4K$63.5K$26.168.66x
99215Office/outpatient visit, est patient, high1.6K$42.3K$26.158.02x
99223Initial hospital care, high complexity1.2K$31.8K$26.169.15x
99232Subsequent hospital care, moderate971$25.4K$26.176.47x
93000Electrocardiogram, complete809$21.2K$26.179.24x
71046Chest X-ray, 2 views694$18.1K$26.156.59x
80053Comprehensive metabolic panel607$15.9K$26.168.56x
85025Complete blood count (CBC)540$14.1K$26.149.27x
36415Venipuncture486$12.7K$26.147.76x

Markup Analysis

Charge-to-Payment Ratio

8.03x

This provider submits charges 8.03 times higher than what Medicare actually pays.

What This Means

A markup ratio of 8.03x means for every $100 Medicare pays, this provider initially charges $803. This is higher than the national average.

Location

West Columbia, SC

Provider Verification

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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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

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