Statistical flag only — not an accusation of fraud
This provider's $404.3K in total Medicare payments ranks in the 98th percentile of Obstetrics & Gynecology providers nationally.
Their average markup ratio of 10.25x 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 70/100. 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 | $838.35 | $81.79 | 10.25x | $756.56 | $28.3K | 346 | 217 |
| 2015 | $837.63 | $81.72 | 10.25x | $755.91 | $30.7K | 376 | 236 |
| 2016 | $836.91 | $81.65 | 10.25x | $755.26 | $33.2K | 406 | 254 |
| 2017 | $838.35 | $81.79 | 10.25x | $756.56 | $35.6K | 435 | 273 |
| 2018 | $837.73 | $81.73 | 10.25x | $756.00 | $38.0K | 465 | 291 |
| 2019 | $837.12 | $81.67 | 10.25x | $755.45 | $40.4K | 495 | 310 |
| 2020 | $838.25 | $81.78 | 10.25x | $756.47 | $42.9K | 524 | 329 |
| 2021 | $837.73 | $81.73 | 10.25x | $756.00 | $45.3K | 554 | 347 |
| 2022 | $837.32 | $81.69 | 10.25x | $755.63 | $47.7K | 584 | 366 |
| 2023 | $838.25 | $81.78 | 10.25x | $756.47 | $50.1K | 613 | 384 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office/outpatient visit, est patient, low | 1.7K | $138.0K | $81.72 | 11.49x |
| 99214 | Office/outpatient visit, est patient, moderate | 844 | $69.0K | $81.77 | 10.53x |
| 99215 | Office/outpatient visit, est patient, high | 563 | $46.0K | $81.72 | 8.97x |
| 99223 | Initial hospital care, high complexity | 422 | $34.5K | $81.77 | 9.84x |
| 99232 | Subsequent hospital care, moderate | 338 | $27.6K | $81.67 | 9.58x |
| 93000 | Electrocardiogram, complete | 281 | $23.0K | $81.87 | 11.38x |
| 71046 | Chest X-ray, 2 views | 241 | $19.7K | $81.82 | 11.50x |
| 80053 | Comprehensive metabolic panel | 211 | $17.3K | $81.77 | 10.82x |
| 85025 | Complete blood count (CBC) | 188 | $15.3K | $81.58 | 8.93x |
| 36415 | Venipuncture | 169 | $13.8K | $81.67 | 10.34x |
This provider submits charges 10.25 times higher than what Medicare actually pays.
A markup ratio of 10.25x means for every $100 Medicare pays, this provider initially charges $1025. 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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