Statistical flag only — not an accusation of fraud
This provider's $1.9M in total Medicare payments ranks in the 91th percentile of Hematology-Oncology providers nationally.
Their average markup ratio of 28.09x is significantly above the specialty median of 3.5x.
Medicare payments to this provider grew 77% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 67/100. 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 | $476.13 | $16.95 | 28.09x | $459.18 | $135.2K | 8.0K | 186 |
| 2015 | $476.13 | $16.95 | 28.09x | $459.18 | $146.8K | 8.7K | 202 |
| 2016 | $476.13 | $16.95 | 28.09x | $459.18 | $158.4K | 9.3K | 218 |
| 2017 | $476.13 | $16.95 | 28.09x | $459.18 | $170.0K | 10.0K | 234 |
| 2018 | $476.13 | $16.95 | 28.09x | $459.18 | $181.6K | 10.7K | 250 |
| 2019 | $476.13 | $16.95 | 28.09x | $459.18 | $193.2K | 11.4K | 266 |
| 2020 | $476.13 | $16.95 | 28.09x | $459.18 | $204.8K | 12.1K | 282 |
| 2021 | $476.13 | $16.95 | 28.09x | $459.18 | $216.4K | 12.8K | 298 |
| 2022 | $476.13 | $16.95 | 28.09x | $459.18 | $227.9K | 13.4K | 314 |
| 2023 | $476.13 | $16.95 | 28.09x | $459.18 | $239.5K | 14.1K | 330 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office/outpatient visit, est patient, low | 38.9K | $659.5K | $16.95 | 29.23x |
| 99214 | Office/outpatient visit, est patient, moderate | 19.5K | $329.8K | $16.95 | 29.37x |
| 99215 | Office/outpatient visit, est patient, high | 13.0K | $219.8K | $16.95 | 24.80x |
| 99223 | Initial hospital care, high complexity | 9.7K | $164.9K | $16.95 | 29.21x |
| 99232 | Subsequent hospital care, moderate | 7.8K | $131.9K | $16.95 | 24.50x |
| 93000 | Electrocardiogram, complete | 6.5K | $109.9K | $16.95 | 31.19x |
| 71046 | Chest X-ray, 2 views | 5.6K | $94.2K | $16.95 | 33.11x |
| 80053 | Comprehensive metabolic panel | 4.9K | $82.4K | $16.95 | 26.98x |
| 85025 | Complete blood count (CBC) | 4.3K | $73.3K | $16.95 | 25.14x |
| 36415 | Venipuncture | 3.9K | $66.0K | $16.95 | 23.23x |
This provider submits charges 28.09 times higher than what Medicare actually pays.
A markup ratio of 28.09x means for every $100 Medicare pays, this provider initially charges $2809. 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.
Other Hematology-Oncology providers in CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Luke Dreisbach, M.D. | Rancho Mirage, CA | $77.2M | ✓ Clear |
| Sachin Gupta, M.D. | Fresno, CA | $55.1M | ✓ Clear |
| Ravi Rao, MD | Fresno, CA | $49.1M | ⚠️ Flagged |
| Michael Sherman, M.D., PHD | Walnut Creek, CA | $38.9M | ✓ Clear |
| Nerses Tchekmedyian, M.D. | Irvine, CA | $38.0M | ✓ Clear |
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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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