Statistical flag only — not an accusation of fraud
This provider's $310.3K in total Medicare payments ranks in the 98th percentile of Obstetrics & Gynecology providers nationally.
Their average markup ratio of 16.01x is significantly above the specialty median of 3.1x.
Medicare payments to this provider grew 90% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 72/100. 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 | $208.70 | $56.80 | 3.67x | $151.90 | $16.6K | 292 | 104 |
| 2015 | $85.69 | $56.84 | 1.51x | $28.85 | $21.4K | 376 | 134 |
| 2016 | $129.64 | $56.91 | 2.28x | $72.73 | $19.5K | 343 | 122 |
| 2017 | $168.60 | $56.85 | 2.97x | $111.75 | $25.8K | 454 | 162 |
| 2018 | $206.53 | $56.83 | 3.63x | $149.70 | $25.1K | 441 | 157 |
| 2019 | $224.53 | $56.93 | 3.94x | $167.60 | $25.0K | 440 | 157 |
| 2020 | $115.29 | $56.93 | 2.03x | $58.36 | $28.8K | 506 | 181 |
| 2021 | $147.46 | $56.93 | 2.59x | $90.53 | $27.1K | 476 | 170 |
| 2022 | $214.72 | $56.86 | 3.78x | $157.86 | $25.8K | 454 | 162 |
| 2023 | $168.73 | $56.85 | 2.97x | $111.88 | $31.5K | 554 | 197 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office visit, 30-39 min | 1.6K | $92.0K | $56.87 | 4.51x |
| 99213 | Established patient office visit, 20-29 min | 402 | $22.9K | $56.89 | 3.37x |
| 99215 | Established patient office visit, 40-54 min | 440 | $25.0K | $56.90 | 3.24x |
| 99232 | Subsequent hospital care, moderate complexity | 173 | $9.8K | $56.88 | 5.92x |
| 99223 | Initial hospital care, high complexity | 176 | $10.0K | $57.03 | 5.70x |
| G0463 | Hospital outpatient clinic visit | 238 | $13.5K | $56.89 | 3.47x |
| 99212 | Established patient office visit, 10-19 min | 162 | $9.2K | $57.03 | 1.61x |
| 93000 | Electrocardiogram, complete | 186 | $10.6K | $56.87 | 2.15x |
| 36415 | Venipuncture | 116 | $6.6K | $56.94 | 5.08x |
| 96372 | Therapeutic injection, subcutaneous or IM | 147 | $8.4K | $56.86 | 5.81x |
This provider submits charges 16.01 times higher than what Medicare actually pays.
A markup ratio of 16.01x means for every $100 Medicare pays, this provider initially charges $1601. 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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