Statistical flag only — not an accusation of fraud
This provider's $390.6K in total Medicare payments ranks in the 98th percentile of Obstetrics & Gynecology providers nationally.
Their average markup ratio of 7.18x 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 71/100. Statistical flags are not accusations of fraud.
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 | $139.94 | $19.49 | 7.18x | $120.45 | $27.3K | 1.4K | 421 |
| 2015 | $139.94 | $19.49 | 7.18x | $120.45 | $29.7K | 1.5K | 457 |
| 2016 | $139.94 | $19.49 | 7.18x | $120.45 | $32.0K | 1.6K | 493 |
| 2017 | $139.87 | $19.48 | 7.18x | $120.39 | $34.4K | 1.8K | 529 |
| 2018 | $139.94 | $19.49 | 7.18x | $120.45 | $36.7K | 1.9K | 565 |
| 2019 | $139.94 | $19.49 | 7.18x | $120.45 | $39.1K | 2.0K | 602 |
| 2020 | $139.94 | $19.49 | 7.18x | $120.45 | $41.4K | 2.1K | 638 |
| 2021 | $139.94 | $19.49 | 7.18x | $120.45 | $43.7K | 2.2K | 674 |
| 2022 | $139.94 | $19.49 | 7.18x | $120.45 | $46.1K | 2.4K | 710 |
| 2023 | $139.94 | $19.49 | 7.18x | $120.45 | $48.4K | 2.5K | 746 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office/outpatient visit, est patient, low | 6.8K | $133.4K | $19.49 | 5.75x |
| 99214 | Office/outpatient visit, est patient, moderate | 3.4K | $66.7K | $19.49 | 8.03x |
| 99215 | Office/outpatient visit, est patient, high | 2.3K | $44.5K | $19.49 | 6.50x |
| 99223 | Initial hospital care, high complexity | 1.7K | $33.3K | $19.48 | 7.62x |
| 99232 | Subsequent hospital care, moderate | 1.4K | $26.7K | $19.50 | 6.93x |
| 93000 | Electrocardiogram, complete | 1.1K | $22.2K | $19.50 | 7.68x |
| 71046 | Chest X-ray, 2 views | 977 | $19.1K | $19.50 | 5.85x |
| 80053 | Comprehensive metabolic panel | 855 | $16.7K | $19.50 | 7.23x |
| 85025 | Complete blood count (CBC) | 760 | $14.8K | $19.50 | 6.34x |
| 36415 | Venipuncture | 684 | $13.3K | $19.50 | 6.26x |
This provider submits charges 7.18 times higher than what Medicare actually pays.
A markup ratio of 7.18x means for every $100 Medicare pays, this provider initially charges $718. 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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