Statistical flag only — not an accusation of fraud
This provider averages 102 services per working day
Based on 253.9K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $2.2M in total Medicare payments ranks in the 97th percentile of Hematology providers nationally.
Their average markup ratio of 9.88x is significantly above the specialty median of 3.8x.
Averaging 102 services per working day raises questions about billing patterns.
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 | $29.29 | $8.83 | 3.32x | $20.46 | $153.0K | 17.3K | 1.4K |
| 2015 | $30.78 | $8.83 | 3.49x | $21.95 | $150.6K | 17.1K | 1.4K |
| 2016 | $22.80 | $8.83 | 2.58x | $13.97 | $138.7K | 15.7K | 1.3K |
| 2017 | $15.37 | $8.83 | 1.74x | $6.54 | $175.8K | 19.9K | 1.6K |
| 2018 | $26.62 | $8.83 | 3.01x | $17.79 | $183.6K | 20.8K | 1.7K |
| 2019 | $28.07 | $8.83 | 3.18x | $19.24 | $160.3K | 18.1K | 1.5K |
| 2020 | $13.76 | $8.83 | 1.56x | $4.93 | $182.4K | 20.6K | 1.7K |
| 2021 | $22.42 | $8.83 | 2.54x | $13.59 | $226.2K | 25.6K | 2.1K |
| 2022 | $30.07 | $8.83 | 3.41x | $21.24 | $186.9K | 21.2K | 1.7K |
| 2023 | $23.95 | $8.83 | 2.71x | $15.12 | $197.6K | 22.4K | 1.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office visit, 30-39 min | 57.0K | $503.3K | $8.83 | 2.76x |
| 99213 | Established patient office visit, 20-29 min | 18.7K | $165.2K | $8.83 | 1.66x |
| 99215 | Established patient office visit, 40-54 min | 9.4K | $83.3K | $8.83 | 5.74x |
| 99232 | Subsequent hospital care, moderate complexity | 21.3K | $188.2K | $8.83 | 5.33x |
| 99223 | Initial hospital care, high complexity | 8.7K | $76.5K | $8.83 | 3.65x |
| G0463 | Hospital outpatient clinic visit | 5.4K | $47.5K | $8.83 | 3.32x |
| 99212 | Established patient office visit, 10-19 min | 15.5K | $136.7K | $8.83 | 5.56x |
| 93000 | Electrocardiogram, complete | 12.4K | $109.5K | $8.83 | 3.70x |
| 36415 | Venipuncture | 8.6K | $75.8K | $8.83 | 2.94x |
| 96372 | Therapeutic injection, subcutaneous or IM | 4.9K | $43.4K | $8.83 | 5.03x |
This provider submits charges 9.88 times higher than what Medicare actually pays.
A markup ratio of 9.88x means for every $100 Medicare pays, this provider initially charges $988. 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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