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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
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Methodology•Download Data
  1. Home
  2. Specialties
  3. Nurse Practitioner
  4. Fraud Risk

Medicare Fraud Risk in Nurse Practitioner

23 flagged Nurse Practitioner providers identified through statistical anomaly detection.

Share:

Flagged Providers

23

of 1.2M total

Average Risk Score

71/100

Specialty Markup

3.5x

Total Payments

$31.5B

Most Common Fraud Flags

Types of billing anomalies most frequently detected among flagged Nurse Practitioner providers.

💰 Outlier Spending23 providers
👥 Beneficiary Stuffing23 providers
📊 Volume Anomaly23 providers
📈 High Markup19 providers

Top Flagged Nurse Practitioner Providers

ProviderLocationRisk ScoreTotal PaymentsMarkupFlags
Merry TaheriTorrance, CA96$12.1M25.4xoutlier spending, high markup
Sarah FinchHutchinson, KS85$6.2M19.8xoutlier spending, high markup
Amanda MckeeMount Vernon, IL76$5.5M9.8xoutlier spending, high markup
Sheeba MathaiFrisco, TX75$16.2M7.0xoutlier spending, beneficiary stuffing
Philana McdonaldAtascadero, CA71$6.9M1.0xoutlier spending, beneficiary stuffing
Mayra FloresSanta Cruz, CA71$6.0M1.0xoutlier spending, beneficiary stuffing
Debra GrinerCasper, WY71$622.8K18.9xoutlier spending, high markup
Mary DeckerQuincy, IL71$541.8K25.3xoutlier spending, high markup
Wendy PrewettTyler, TX70$2.9M12.4xoutlier spending, high markup
Joel LuriePlano, TX70$2.8M9.4xoutlier spending, high markup
Kristin GundtGrand Junction, CO70$364.2K82.4xoutlier spending, high markup
Lisa HoukPilot Point, TX69$289.2K20.7xoutlier spending, high markup
Courtney WilliamsWestminster, CO68$4.1M2.6xoutlier spending, beneficiary stuffing
Rosalio GallegosSan Antonio, TX68$2.2M8.9xoutlier spending, high markup
Anna MillerCharleston, SC68$1.1M16.7xoutlier spending, high markup
Tracie WoodwardHartsville, SC68$162.5K38.5xoutlier spending, high markup
Lindsay GambleOkatie, SC67$3.7M7.6xoutlier spending, high markup
Jennifer WeedAbington, PA67$413.1K49.3xoutlier spending, high markup
Lisa Perez9702407734, CO67$300.0K99.3xoutlier spending, high markup
Whitley WeatherfordScranton, SC66$2.7M8.7xoutlier spending, high markup
Morgan ClickDallas, TX66$2.1M10.8xoutlier spending, high markup
Samantha WildSan Antonio, TX66$2.0M8.6xoutlier spending, high markup
Busola AmurawaiyeRockwall, TX66$1.7M11.6xoutlier spending, high markup

Markup by Specialty

How Nurse Practitioner markup compares to other specialties.

Anesthesiology Assistant
12.2x
Dental Anesthesiology
12.2x
Certified Registered Nurse Anesthetist (CRNA)
9.7x
Anesthesiologist Assistants
9.6x
Anesthesiology
8.8x
CRNA
7.4x
Emergency Medicine
7.1x
Radiation Therapy Center
7.1x
Radiation Therapy
6.1x
Ambulatory Surgical Center
6.1x
Independent Diagnostic Testing Facility (IDTF)
6.1x
Neurosurgery
5.9x
Independent Diagnostic Testing Facility
5.5x
Diagnostic Radiology
5.4x
Interventional Radiology
5.1x

⚠️ Disclaimer: Being flagged does not imply fraud. These providers were identified through statistical analysis of billing patterns that deviate significantly from peers. Unusual billing may have legitimate explanations. This data is provided for transparency and public accountability purposes only.

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • OpenMedicare Statistical Anomaly Detection

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.