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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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    © 2026 OpenMedicare. Independent data journalism. Built by TheDataProject.ai

    Methodology•Download Data
    1. Home
    2. Providers
    3. Theresa Soto
    ⚕️
    MDIndividual

    Theresa Soto, MD

    NPI: 1760442966
    Herndon, VA
    10 years of data
    Obstetrics & Gynecology
    $6.5M
    Total Payments
    15.9K
    Beneficiaries
    25.9K
    Services
    3.48x
    Markup Ratio

    Peer Comparison

    99th
    percentile in specialty
    This provider$6.5M
    Specialty median$14.0K

    📋 Key Findings

    1Billed $6.5M over 10 years
    23.48x markup ratio (above median)
    399th percentile in Obstetrics & Gynecology by payments
    4Payments surged 400% in 2015
    513 procedures with >3x markup
    ✓ No flags detected

    🔎 Data Analysis

    This provider's $6.5M in total Medicare payments ranks in the 99th percentile of Obstetrics & Gynecology providers nationally.

    Medicare payments to this provider grew 450% from 2014 to 2023.

    AI-generated analysis based on Medicare payment data.

    Annual Medicare Payments

    Annual Services Provided

    Avg Payment per Service

    Markup Ratio Over Time

    📈

    Notable: Payments increased 400% in 2015

    Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.

    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$1.8K$518.923.48x$1.3K$128.0K249191
    2015$1.5K$370.554.03x$1.1K$639.3K3.4K1.9K
    2016$1.5K$361.594.14x$1.1K$618.3K3.9K2.3K
    2017$1.8K$377.584.72x$1.4K$454.7K2.7K1.4K
    2018$1.6K$448.673.61x$1.2K$697.0K2.5K1.4K
    2019$1.6K$474.773.43x$1.2K$903.8K3.0K2.0K
    2020$1.5K$455.133.37x$1.1K$741.1K2.7K1.8K
    2021$1.3K$415.133.05x$849.56$869.3K2.5K1.7K
    2022$1.5K$425.623.62x$1.1K$710.4K2.4K1.6K
    2023$1.5K$381.443.87x$1.1K$703.1K2.6K1.7K

    Top Procedures (20)

    36465Injection of chemical agent into single incompetent vein of leg using ultrasound guidance
    $1.1M
    901 services$1.2K/svc2.66x markup
    93970Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers⚠ 3.9x markup
    $1.0M
    7.2K services$145.12/svc3.86x markup
    36466Injection of chemical agent into multiple incompetent veins of same leg using ultrasound guidance
    $1.0M
    807 services$1.3K/svc2.73x markup
    93971Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers⚠ 3.8x markup
    $783.9K
    8.3K services$94.50/svc3.81x markup
    36482Chemical destruction of incompetent vein of arm or leg, accessed through the skin using imaging guidance
    $643.9K
    411 services$1.6K/svc2.87x markup
    36475Destruction of insufficient vein of arm or leg, accessed through the skin⚠ 4.5x markup
    $596.5K
    517 services$1.2K/svc4.45x markup
    36478Laser destruction of incompetent vein of arm or leg using imaging guidance, accessed through the skin⚠ 4.0x markup
    $353.3K
    337 services$1.0K/svc3.96x markup
    36471Injection of chemical agent into multiple veins of same leg⚠ 4.1x markup
    $276.0K
    1.8K services$149.84/svc4.11x markup
    99204New patient office or other outpatient visit, typically 45 minutes⚠ 3.5x markup
    $239.3K
    1.9K services$129.34/svc3.48x markup
    99213Established patient office or other outpatient visit, typically 15 minutes⚠ 3.0x markup
    $126.8K
    2.0K services$62.30/svc3.05x markup
    36473Mechanicochemical destruction of insufficient vein of arm or leg, accessed through the skin using imaging guidance⚠ 3.8x markup
    $114.4K
    100 services$1.1K/svc3.76x markup
    37799Blood vessel procedure⚠ 8.1x markup
    $44.1K
    239 services$184.44/svc8.13x markup
    76942Ultrasonic guidance imaging supervision and interpretation for insertion of needle⚠ 12.1x markup
    $37.0K
    733 services$50.48/svc12.08x markup
    36470Injection of chemical agent into single incompetent vein⚠ 4.3x markup
    $18.8K
    203 services$92.41/svc4.33x markup
    99214Established patient office or other outpatient, visit typically 25 minutes
    $13.2K
    134 services$98.35/svc2.95x markup
    99203New patient office or other outpatient visit, typically 30 minutes⚠ 3.2x markup
    $7.2K
    79 services$90.52/svc3.20x markup
    99212Established patient office or other outpatient visit, typically 10 minutes
    $4.9K
    117 services$42.06/svc2.85x markup
    99205New patient office or other outpatient visit, 60-74 minutes
    $2.5K
    13 services$190.43/svc2.99x markup
    29580Strapping, unna boot
    $1.0K
    18 services$57.43/svc1.74x markup
    99202New patient office or other outpatient visit, typically 20 minutes⚠ 3.2x markup
    $822.29
    13 services$63.25/svc3.16x markup
    Show detailed table ▾
    CodeDescriptionServicesPaymentsAvg/ServiceMarkup
    36465Injection of chemical agent into single incompetent vein of leg using ultrasound guidance901$1.1M$1.2K2.66x
    93970Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers7.2K$1.0M$145.123.86x
    36466Injection of chemical agent into multiple incompetent veins of same leg using ultrasound guidance807$1.0M$1.3K2.73x
    93971Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers8.3K$783.9K$94.503.81x
    36482Chemical destruction of incompetent vein of arm or leg, accessed through the skin using imaging guidance411$643.9K$1.6K2.87x
    36475Destruction of insufficient vein of arm or leg, accessed through the skin517$596.5K$1.2K4.45x
    36478Laser destruction of incompetent vein of arm or leg using imaging guidance, accessed through the skin337$353.3K$1.0K3.96x
    36471Injection of chemical agent into multiple veins of same leg1.8K$276.0K$149.844.11x
    99204New patient office or other outpatient visit, typically 45 minutes1.9K$239.3K$129.343.48x
    99213Established patient office or other outpatient visit, typically 15 minutes2.0K$126.8K$62.303.05x
    36473Mechanicochemical destruction of insufficient vein of arm or leg, accessed through the skin using imaging guidance100$114.4K$1.1K3.76x
    37799Blood vessel procedure239$44.1K$184.448.13x
    76942Ultrasonic guidance imaging supervision and interpretation for insertion of needle733$37.0K$50.4812.08x
    36470Injection of chemical agent into single incompetent vein203$18.8K$92.414.33x
    99214Established patient office or other outpatient, visit typically 25 minutes134$13.2K$98.352.95x
    99203New patient office or other outpatient visit, typically 30 minutes79$7.2K$90.523.20x
    99212Established patient office or other outpatient visit, typically 10 minutes117$4.9K$42.062.85x
    99205New patient office or other outpatient visit, 60-74 minutes13$2.5K$190.432.99x
    29580Strapping, unna boot18$1.0K$57.431.74x
    99202New patient office or other outpatient visit, typically 20 minutes13$822.29$63.253.16x

    Markup Analysis

    Charge-to-Payment Ratio

    3.48x

    This provider submits charges 3.48 times higher than what Medicare actually pays.

    What This Means

    A markup ratio of 3.48x means for every $100 Medicare pays, this provider initially charges $348. This is higher than the national average.

    Location

    Herndon, VA

    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