Statistical flag only — not an accusation of fraud
This provider's $144.0K in total Medicare payments ranks in the 33th percentile of Clinic or Group Practice providers nationally.
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 | $50.03 | $10.19 | 4.91x | $39.84 | $10.1K | 989 | 762 |
| 2015 | $50.03 | $10.19 | 4.91x | $39.84 | $10.9K | 1.1K | 827 |
| 2016 | $50.03 | $10.19 | 4.91x | $39.84 | $11.8K | 1.2K | 892 |
| 2017 | $49.98 | $10.18 | 4.91x | $39.80 | $12.7K | 1.2K | 957 |
| 2018 | $49.98 | $10.18 | 4.91x | $39.80 | $13.5K | 1.3K | 1.0K |
| 2019 | $50.03 | $10.19 | 4.91x | $39.84 | $14.4K | 1.4K | 1.1K |
| 2020 | $50.03 | $10.19 | 4.91x | $39.84 | $15.3K | 1.5K | 1.2K |
| 2021 | $50.03 | $10.19 | 4.91x | $39.84 | $16.1K | 1.6K | 1.2K |
| 2022 | $49.98 | $10.18 | 4.91x | $39.80 | $17.0K | 1.7K | 1.3K |
| 2023 | $49.98 | $10.18 | 4.91x | $39.80 | $17.9K | 1.8K | 1.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office/outpatient visit, est patient, low | 4.8K | $49.1K | $10.18 | 4.87x |
| 99214 | Office/outpatient visit, est patient, moderate | 2.4K | $24.6K | $10.18 | 4.98x |
| 99215 | Office/outpatient visit, est patient, high | 1.6K | $16.4K | $10.18 | 5.04x |
| 99223 | Initial hospital care, high complexity | 1.2K | $12.3K | $10.19 | 4.59x |
| 99232 | Subsequent hospital care, moderate | 965 | $9.8K | $10.19 | 4.82x |
| 93000 | Electrocardiogram, complete | 804 | $8.2K | $10.19 | 5.61x |
| 71046 | Chest X-ray, 2 views | 689 | $7.0K | $10.19 | 4.92x |
| 80053 | Comprehensive metabolic panel | 603 | $6.1K | $10.19 | 5.55x |
| 85025 | Complete blood count (CBC) | 536 | $5.5K | $10.19 | 5.75x |
| 36415 | Venipuncture | 483 | $4.9K | $10.18 | 5.04x |
This provider submits charges 4.91 times higher than what Medicare actually pays.
A markup ratio of 4.91x means for every $100 Medicare pays, this provider initially charges $491. 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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