Our machine learning model analyzed billing patterns, service volumes, markup ratios, and peer comparisons to estimate a 90.9% probability that this provider's billing patterns are consistent with known fraud cases. This is ranked #113 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 $1.3M in total Medicare payments ranks in the 97th percentile of Podiatry providers nationally.
Medicare payments to this provider grew 118% 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 | 6.3K | $286.9K | $45.55 | 1.61x |
| 99214 | Office visit, established patient, moderate complexity | 5.7K | $258.2K | $45.55 | 1.69x |
| 99215 | Office visit, established patient, high complexity | 5.0K | $229.5K | $45.55 | 1.87x |
| 99232 | Subsequent hospital care, moderate complexity | 4.4K | $200.8K | $45.55 | 1.82x |
| 99233 | Subsequent hospital care, high complexity | 3.8K | $172.1K | $45.54 | 1.78x |
| 93000 | Electrocardiogram, complete | 3.1K | $143.4K | $45.55 | 1.35x |
| 71046 | Chest X-ray, 2 views | 2.5K | $114.7K | $45.55 | 1.70x |
| 80053 | Comprehensive metabolic panel | 1.9K | $86.1K | $45.56 | 1.57x |
| 85025 | Complete blood count with differential | 1.3K | $57.4K | $45.53 | 1.71x |
| 36415 | Venipuncture for blood draw | 630 | $28.7K | $45.53 | 1.80x |
This provider submits charges 1.64 times higher than what Medicare actually pays.
A markup ratio of 1.64x means for every $100 Medicare pays, this provider initially charges $164. This is lower 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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