Statistical flag only — not an accusation of fraud
This provider averages 82 services per working day
Based on 205.0K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $34.5M in total Medicare payments ranks in the 99th percentile of General Practice providers nationally.
Averaging 82 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 23160% 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.
Notable: Payments increased 355% in 2017
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $125.97 | $66.47 | 1.90x | $59.50 | $74.0K | 1.1K | 11 |
| 2015 | $157.43 | $73.87 | 2.13x | $83.56 | $131.4K | 1.8K | 15 |
| 2016 | $181.25 | $82.82 | 2.19x | $98.43 | $389.4K | 4.7K | 24 |
| 2017 | $192.80 | $91.97 | 2.10x | $100.83 | $1.8M | 19.3K | 28 |
| 2018 | $183.07 | $80.01 | 2.29x | $103.06 | $1.8M | 22.7K | 29 |
| 2019 | $259.76 | $85.48 | 3.04x | $174.28 | $1.7M | 19.7K | 34 |
| 2020 | $286.64 | $99.27 | 2.89x | $187.37 | $2.5M | 25.4K | 43 |
| 2021 | $304.48 | $102.79 | 2.96x | $201.69 | $3.3M | 32.5K | 51 |
| 2022 | $407.97 | $158.27 | 2.58x | $249.70 | $5.6M | 35.3K | 54 |
| 2023 | $696.25 | $404.06 | 1.72x | $292.19 | $17.2M | 42.6K | 51 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| Q4236 | Carepatch, per square centimeter | 13.4K | $12.9M | $965.78 | 1.36x |
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 11.3K | $2.2M | $195.54 | 2.61x |
| Q4188 | Amnioarmor, per square centimeter | 3.4K | $2.2M | $629.92 | 1.28x |
| G0181 | Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow | 17.8K | $1.5M | $82.37 | 1.99x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 13.6K | $1.5M | $107.77 | 3.60x |
| 97610 | Therapy procedure using ultrasound | 2.7K | $1.1M | $423.63 | 3.89x |
| 95923 | Testing of autonomic (sympathetic) nervous system function | 9.9K | $1.1M | $113.91 | 3.27x |
| Q4158 | Kerecis omega3, per square centimeter | 2.5K | $1.1M | $436.82 | 1.28x |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 12.5K | $988.3K | $78.95 | 3.31x |
| 93923 | Complete ultrasound study of arm and leg arteries | 8.1K | $970.4K | $120.46 | 2.87x |
| 92540 | Evaluation and testing for balance with recording | 8.1K | $771.2K | $95.57 | 4.13x |
| 92546 | Test for abnormal eye movement using a rotating chair | 6.6K | $714.8K | $107.56 | 4.52x |
| 99336 | Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes | 6.2K | $707.0K | $114.64 | 3.87x |
| 95921 | Testing of autonomic nervous system function and heart rate response to deep breathing | 9.9K | $699.9K | $70.61 | 2.73x |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 4.9K | $645.5K | $131.74 | 1.81x |
| 99345 | Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes | 4.1K | $631.2K | $155.02 | 1.98x |
| 11046 | Removal of muscle and/or tissue, each additional 20.0 sq cm or less | 7.1K | $451.4K | $63.60 | 2.54x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 6.8K | $391.8K | $57.34 | 2.05x |
| 11044 | Removal of bone, 20.0 sq cm or less | 1.3K | $344.4K | $274.45 | 2.54x |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 3.6K | $322.1K | $89.76 | 2.95x |
This provider submits charges 2.19 times higher than what Medicare actually pays.
A markup ratio of 2.19x means for every $100 Medicare pays, this provider initially charges $219. 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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