← Back to all reports
Donald Zeller
Disclaimer: This report is a statistical analysis of publicly available Medicare data.
The anomalies identified herein do not necessarily constitute findings or accusations of fraud.
Statistical deviation from peer benchmarks may have legitimate clinical or business explanations.
All patterns warrant further investigation and independent verification.
Composite Score
35.3
Risk Classification
watchlist
Anomaly Signals
3
Analysis Period
2021–2023
Executive Summary
Donald Zeller (NPI: 1154360733), a Pathology provider in Palm Beach Gardens, FL, has been identified as a WATCHLIST-tier anomaly risk with a composite score of 66.8/100. Zervio.ai detected 24 independent statistical anomalies across 3 categories, with significant estimated overpayments identified across multiple billing categories. This provider's Medicare billing is 25.2x the specialty median.
Key Findings
- Provider reassigned to multiple group practices with aggregate billing exceeding individual thresholds
- Total billing volume is a statistical outlier among specialty peers
- Average payment per service significantly exceeds specialty peers
BILLING ANOMALY ANALYSIS — Detailed statistical breakdown across 3 independent signals.
Peer comparison data showing deviation from specialty benchmarks. Financial impact assessment
with estimated overpayment calculations. Timeline and trend analysis showing multi-year patterns.
Prescribing analysis with controlled substance review. Industry payment correlation analysis.
Evidence strength assessment with corroboration matrix. Entity resolution findings.
Legal framework mapping to applicable False Claims Act provisions.
FINANCIAL IMPACT ASSESSMENT — Estimated single damages calculation. Treble damage projection
under 31 U.S.C. 3729. Per-claim civil penalty estimates ($13,946 to $27,894 per false claim).
Recovery breakdown by anomaly category.
PEER COMPARISON — Provider vs. specialty median, 90th percentile, and 95th percentile across
payment per service, services per beneficiary, and high-complexity coding ratio.
Data Sources: CMS Medicare Provider Utilization & Payment Data (Part B, 2021–2023),
CMS Part D Prescriber Data (2021–2023), CMS Open Payments (2021–2023),
HHS-OIG LEIE Exclusion List, NPPES NPI Registry. All data is publicly available.