Statistical flag only — not an accusation of fraud
This provider's $2.3M in total Medicare payments ranks in the 99th percentile of Physician Assistant providers nationally.
Medicare payments to this provider grew 77% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 66/100. 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 | $208.24 | $49.70 | 4.19x | $158.54 | $159.8K | 3.2K | 1.9K |
| 2015 | $208.24 | $49.70 | 4.19x | $158.54 | $173.5K | 3.5K | 2.0K |
| 2016 | $208.24 | $49.70 | 4.19x | $158.54 | $187.2K | 3.8K | 2.2K |
| 2017 | $208.24 | $49.70 | 4.19x | $158.54 | $200.9K | 4.0K | 2.4K |
| 2018 | $208.24 | $49.70 | 4.19x | $158.54 | $214.6K | 4.3K | 2.5K |
| 2019 | $208.20 | $49.69 | 4.19x | $158.51 | $228.3K | 4.6K | 2.7K |
| 2020 | $208.24 | $49.70 | 4.19x | $158.54 | $242.0K | 4.9K | 2.8K |
| 2021 | $208.24 | $49.70 | 4.19x | $158.54 | $255.7K | 5.1K | 3.0K |
| 2022 | $208.20 | $49.69 | 4.19x | $158.51 | $269.4K | 5.4K | 3.2K |
| 2023 | $208.24 | $49.70 | 4.19x | $158.54 | $283.1K | 5.7K | 3.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office/outpatient visit, est patient, low | 15.7K | $779.6K | $49.70 | 3.47x |
| 99214 | Office/outpatient visit, est patient, moderate | 7.8K | $389.8K | $49.70 | 4.70x |
| 99215 | Office/outpatient visit, est patient, high | 5.2K | $259.9K | $49.70 | 4.05x |
| 99223 | Initial hospital care, high complexity | 3.9K | $194.9K | $49.69 | 3.91x |
| 99232 | Subsequent hospital care, moderate | 3.1K | $155.9K | $49.70 | 3.74x |
| 93000 | Electrocardiogram, complete | 2.6K | $129.9K | $49.71 | 4.77x |
| 71046 | Chest X-ray, 2 views | 2.2K | $111.4K | $49.70 | 4.20x |
| 80053 | Comprehensive metabolic panel | 2.0K | $97.4K | $49.69 | 3.82x |
| 85025 | Complete blood count (CBC) | 1.7K | $86.6K | $49.70 | 4.50x |
| 36415 | Venipuncture | 1.6K | $78.0K | $49.69 | 4.39x |
This provider submits charges 4.19 times higher than what Medicare actually pays.
A markup ratio of 4.19x means for every $100 Medicare pays, this provider initially charges $419. 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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