Statistical flag only — not an accusation of fraud
This provider's $321.2K in total Medicare payments ranks in the 98th percentile of Obstetrics & Gynecology providers nationally.
Their average markup ratio of 27.75x is significantly above the specialty median of 3.1x.
Medicare payments to this provider grew 93% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 74/100. 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 | $173.47 | $113.91 | 1.52x | $59.56 | $18.0K | 158 | 94 |
| 2015 | $180.75 | $113.87 | 1.59x | $66.88 | $22.1K | 194 | 116 |
| 2016 | $327.49 | $114.19 | 2.87x | $213.30 | $23.3K | 204 | 122 |
| 2017 | $238.45 | $113.85 | 2.09x | $124.60 | $24.7K | 217 | 130 |
| 2018 | $206.85 | $113.79 | 1.82x | $93.06 | $28.6K | 251 | 150 |
| 2019 | $171.81 | $114.00 | 1.51x | $57.81 | $26.3K | 231 | 138 |
| 2020 | $334.44 | $113.83 | 2.94x | $220.61 | $25.8K | 227 | 136 |
| 2021 | $282.13 | $113.90 | 2.48x | $168.23 | $32.8K | 288 | 172 |
| 2022 | $202.79 | $113.80 | 1.78x | $88.99 | $29.5K | 259 | 155 |
| 2023 | $196.25 | $114.10 | 1.72x | $82.15 | $34.8K | 305 | 183 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office visit, 30-39 min | 590 | $67.2K | $113.90 | 3.65x |
| 99213 | Established patient office visit, 20-29 min | 284 | $32.3K | $113.75 | 3.05x |
| 99215 | Established patient office visit, 40-54 min | 222 | $25.2K | $113.72 | 5.56x |
| 99232 | Subsequent hospital care, moderate complexity | 125 | $14.2K | $113.59 | 5.13x |
| 99223 | Initial hospital care, high complexity | 180 | $20.5K | $114.08 | 2.88x |
| G0463 | Hospital outpatient clinic visit | 77 | $8.8K | $113.90 | 5.96x |
| 99212 | Established patient office visit, 10-19 min | 69 | $7.9K | $114.48 | 4.79x |
| 93000 | Electrocardiogram, complete | 83 | $9.5K | $114.02 | 2.40x |
| 36415 | Venipuncture | 146 | $16.6K | $113.88 | 3.15x |
| 96372 | Therapeutic injection, subcutaneous or IM | 136 | $15.5K | $113.67 | 5.06x |
This provider submits charges 27.75 times higher than what Medicare actually pays.
A markup ratio of 27.75x means for every $100 Medicare pays, this provider initially charges $2775. 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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