Statistical flag only — not an accusation of fraud
This provider's $329.6K in total Medicare payments ranks in the 98th percentile of Obstetrics & Gynecology providers nationally.
Their average markup ratio of 143.32x is significantly above the specialty median of 3.1x.
Medicare payments to this provider grew 78% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 79/100. 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 | $96.27 | $62.89 | 1.53x | $33.38 | $20.9K | 332 | 167 |
| 2015 | $219.63 | $63.04 | 3.48x | $156.59 | $23.1K | 366 | 185 |
| 2016 | $221.42 | $62.99 | 3.52x | $158.43 | $20.9K | 331 | 167 |
| 2017 | $115.00 | $62.97 | 1.83x | $52.03 | $21.2K | 336 | 170 |
| 2018 | $227.30 | $62.94 | 3.61x | $164.36 | $24.4K | 388 | 196 |
| 2019 | $129.34 | $63.02 | 2.05x | $66.32 | $25.9K | 411 | 208 |
| 2020 | $108.38 | $62.95 | 1.72x | $45.43 | $29.2K | 464 | 234 |
| 2021 | $123.67 | $63.04 | 1.96x | $60.63 | $26.5K | 421 | 213 |
| 2022 | $224.66 | $62.98 | 3.57x | $161.68 | $28.9K | 459 | 232 |
| 2023 | $178.99 | $62.94 | 2.84x | $116.05 | $37.1K | 589 | 297 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office visit, 30-39 min | 1.3K | $83.2K | $62.96 | 3.80x |
| 99213 | Established patient office visit, 20-29 min | 450 | $28.3K | $62.96 | 2.17x |
| 99215 | Established patient office visit, 40-54 min | 155 | $9.8K | $62.99 | 5.37x |
| 99232 | Subsequent hospital care, moderate complexity | 353 | $22.2K | $62.92 | 2.55x |
| 99223 | Initial hospital care, high complexity | 198 | $12.4K | $62.85 | 2.46x |
| G0463 | Hospital outpatient clinic visit | 291 | $18.3K | $62.92 | 3.60x |
| 99212 | Established patient office visit, 10-19 min | 232 | $14.6K | $63.11 | 3.52x |
| 93000 | Electrocardiogram, complete | 113 | $7.1K | $63.24 | 4.21x |
| 36415 | Venipuncture | 83 | $5.2K | $62.67 | 3.35x |
| 96372 | Therapeutic injection, subcutaneous or IM | 217 | $13.7K | $62.97 | 3.42x |
This provider submits charges 143.32 times higher than what Medicare actually pays.
A markup ratio of 143.32x means for every $100 Medicare pays, this provider initially charges $14332. 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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