Medicare Enrolled
Dr. Paul Speece, M.D.
Radiation Oncology · Fresno, CA
Practice pattern: Mixed Practice
— Diverse clinical practice across multiple procedure types
Very High
DATA COVERAGE
Data in 4 of 4 federal sources
Measures public federal data availability — not provider quality
Informational, not a quality rating.
This page presents federal public records about Dr. Speece from CMS (NPPES, Open Payments, Medicare Provider Utilization, PECOS). It is not medical advice, an endorsement, or a judgment of clinical quality. Always consult the provider directly and a licensed clinician for medical decisions. Read methodology →
Are you Dr. Speece?
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What this data tells you about Dr. Speece
Dr. Paul Speece is a radiation oncology specialist in Fresno, CA, with 20 years of NPI registration. Based on federal Medicare data, Dr. Speece performed 8,004 Medicare services in 2023. These records do not provide a deduplicated patient total.
Between the years covered by Open Payments, Dr. Speece received a total of $2,558 from 14 pharmaceutical and/or device companies across 37 payment records. A record can group multiple payments. These transfers are publicly reported through CMS Open Payments. Disclosure alone does not establish their effect on care. A reliable breakdown by payment category is not available in this snapshot. Patients may wish to discuss these relationships with their provider.
The Data Coverage level for Dr. Speece is Very High — reflecting how much public federal data is available about this provider. Patients are encouraged to use this data as one of several factors when choosing a healthcare provider.
✓ 20 years of NPI registration
▲ Top 23% volume in CA
$2,558 industry payments
Medicare Practice Summary — 2023
Medicare Utilization ↗8,004
Medicare services
Top 23% in CA for radiation oncology
Not available
Unique patients (not deduplicated)
$22
Avg. Medicare payment
Medicare patients only (65+ / disabled) · How to read this →
Top procedures by volume
Ranked by number of services performed for Medicare patients. Avg. submitted charge is what the provider billed; avg. Medicare payment is what CMS paid.
| Procedure | Volume | Avg. paid | Avg. submitted |
|---|---|---|---|
| Contrast dye for imaging (iodine-based) A contrast agent containing 300-399 mg/ml of iodine used to enhance imaging studies. It is administered per milliliter to improve the visibility of internal structures. |
2,967 | $0 | $1 |
| Chest X-ray, 1 view An X-ray image of the chest taken from a single angle. This imaging test is used to visualize the structures within the chest cavity. |
995 | $7 | $37 |
| MRI contrast dye injection (gadobutrol) | 625 | $0 | $1 |
| Sedation by physician, initial 15 minutes Administration of a drug to induce depression of consciousness by the physician performing a procedure. This code covers the initial 15 minutes of sedation for patients aged 5 years or older. |
439 | $12 | $115 |
| Chest X-ray, 2 views An X-ray imaging test of the chest that captures two different angles to visualize the lungs, heart, and chest wall. |
323 | $12 | $60 |
| Chest fluid aspiration with imaging guidance This procedure involves removing fluid from the chest cavity using imaging technology to guide the needle placement. |
239 | $84 | $1,000 |
| Abdominal fluid drainage with imaging guidance Removal of fluid from the abdominal cavity using imaging technology to guide the procedure. |
152 | $80 | $519 |
| Midazolam injection, per 1 mg Administration of midazolam hydrochloride, a sedative medication, measured in 1 mg increments. |
138 | $0 | $10 |
| Ultrasound guidance for blood vessel access Use of ultrasound imaging to help locate and access a blood vessel. This guidance assists healthcare providers in performing procedures such as inserting IV lines or drawing blood. |
110 | $13 | $78 |
| Fluoroscopic guidance for central vein access device Use of live X-ray imaging to guide the placement or removal of a central vein access device. |
106 | $25 | $98 |
| Office visit, established patient (20-29 min) An office visit for an existing patient lasting between 20 and 29 minutes. The visit involves medical evaluation and management of the patient's condition. |
91 | $70 | $161 |
| Fluoroscopic guidance for needle placement Use of real-time X-ray imaging to guide the precise placement of a needle during a medical procedure. |
79 | $38 | $137 |
| Foot X-ray, 3+ views An X-ray imaging test of the foot that captures at least three different views to evaluate the bones and joints. |
64 | $9 | $45 |
| Abdominal X-ray, 1 view An X-ray image of the abdomen taken from a single angle to visualize internal structures. |
62 | $7 | $37 |
| Knee X-ray, 4 or more views An imaging test using X-rays to create multiple pictures of the knee joint from different angles. |
61 | $16 | $62 |
| Radiologist review of CT-guided needle placement A radiologist reviews the CT imaging used to guide the placement of a needle. |
57 | $55 | $275 |
| Hip X-ray, 2-3 views An X-ray imaging test of the hip joint using two to three different angles to visualize the bones and surrounding structures. |
55 | $18 | $75 |
| Bone marrow biopsy and aspiration A procedure to remove a small sample of bone marrow and liquid for laboratory testing. The sample is analyzed to help diagnose various medical conditions. |
54 | $57 | $220 |
| Office visit, established patient (30-39 min) A follow-up office visit for an existing patient lasting between 30 and 39 minutes. The visit involves medical evaluation and management of the patient's condition. |
54 | $103 | $252 |
| Shoulder X-ray, 2+ views An X-ray imaging test of the shoulder joint using at least two different angles to visualize the bones and surrounding structures. |
53 | $13 | $56 |
| CT scan of chest blood vessels with contrast A CT scan that uses contrast dye to create detailed images of the blood vessels in the chest. |
51 | $87 | $829 |
| CT scan of neck blood vessels with contrast A computed tomography scan that uses dye to visualize the blood vessels in the neck. This imaging test helps examine the structure and flow within the neck's vascular system. |
48 | $63 | $350 |
| X-ray of hand, minimum of 3 views An X-ray imaging test of the hand that captures at least three different angles to visualize the bones and joints. |
47 | $12 | $66 |
| Core needle biopsy of lung or mediastinum A procedure to remove a small tissue sample from the lung or the space between the lungs using a needle inserted through the skin. |
46 | $116 | $1,400 |
| Insertion of tunneled central venous catheter for infusion, age 5+ A surgical procedure to place a long-term catheter into a large vein for delivering medications or fluids. The catheter is tunneled under the skin to reduce infection risk and provide stable access for patients aged 5 and older. |
42 | $193 | $1,308 |
| Ultrasound guidance for needle placement Use of ultrasound imaging to guide the precise placement of a needle during a medical procedure. |
36 | $23 | $134 |
| Central venous port insertion A surgical procedure to place a small reservoir under the skin for long-term access to the bloodstream. The device is connected to a vein to allow for repeated medication administration or blood draws. |
35 | $451 | $3,108 |
| Insertion of non-tunneled central venous catheter A procedure to place a central venous catheter for infusion in patients aged 5 years or older. The catheter is inserted directly into a large vein without being tunneled under the skin. |
34 | $66 | $1,045 |
| Radiologist review of abdominal artery image A radiologist reviews images of the arteries in the abdomen to assess their structure and function. |
33 | $75 | $378 |
| Injection, fentanyl citrate, 0.1 mg | 33 | $1 | $8 |
| X-ray of lower and sacral spine, 2-3 views An X-ray imaging test that captures 2 to 3 views of the lower back and sacral spine to visualize the bones and joints in this area. |
31 | $19 | $76 |
| Knee X-ray, 1-2 views An X-ray imaging test of the knee joint using one to two different angles to visualize the bones and surrounding structures. |
31 | $5 | $35 |
| Ultrasound of arm or leg veins An ultrasound exam of the veins in the arm or leg. The test uses sound waves to check blood flow and may include compression and other maneuvers. |
31 | $23 | $208 |
| Cefazolin sodium injection, 500 mg An injection of 500 mg of cefazolin sodium, an antibiotic medication, administered into the body. |
30 | $1 | $10 |
| Lumbar puncture with imaging guidance A procedure to remove spinal fluid from the lower back for diagnostic testing, performed using imaging guidance. |
29 | $63 | $530 |
| Removal of tunneled central venous tube This procedure involves the removal of a catheter that has been surgically placed under the skin and threaded into a large vein. |
27 | $102 | $567 |
| CT scan of abdominal and pelvic blood vessels with contrast A computed tomography scan that uses contrast dye to visualize the blood vessels in the abdomen and pelvis. |
27 | $78 | $707 |
| Ultrasound of arm and leg arteries This procedure uses sound waves to create images of the blood vessels in the arms and legs. It allows healthcare providers to examine the structure and blood flow within these arteries. |
27 | $9 | $51 |
| X-ray of thigh bone, minimum 2 views An X-ray imaging test of the thigh bone using at least two different angles to visualize the bone structure. |
26 | $6 | $33 |
| Ultrasound of head and neck blood flow, bilateral An ultrasound exam that uses sound waves to visualize and assess blood flow in the vessels of both the head and the neck. |
26 | $29 | $122 |
| Needle or tube insertion into hemodialysis circuit with radiologist review A procedure involving the insertion of a needle or tube into a hemodialysis circuit, accompanied by a review of the procedure by a radiologist. |
25 | $112 | $900 |
| Hemodialysis circuit intervention with balloon dilation A procedure to insert a needle or tube into a hemodialysis circuit and dilate the dialysis segment using a balloon, with radiological review. |
24 | $184 | $1,950 |
| Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml | 24 | $1 | $6 |
| Kidney tube placement with imaging guidance A tube is placed into the kidney using imaging guidance. A radiologist reviews the procedure. |
23 | $170 | $1,690 |
| Arterial catheter insertion, initial third order branch Insertion of a tube into an abdominal, pelvic, or leg artery, specifically targeting the initial third order branch. |
22 | $126 | $1,288 |
| X-ray of lower leg, 2 views An X-ray imaging test of the lower leg using two different angles to visualize the bones and surrounding structures. |
21 | $6 | $35 |
| Ultrasound of leg arteries or grafts An imaging test that uses sound waves to create pictures of the blood vessels in the legs or any surgical grafts present. |
21 | $28 | $113 |
| Ultrasound of arm or leg veins An ultrasound exam of the veins in one arm or leg using compression and other maneuvers to assess blood flow and check for blockages. |
21 | $17 | $139 |
| Additional sedation, per 15 minutes Administration of a drug to deepen sedation during a procedure. This code covers each additional 15-minute increment of sedation beyond the initial period. |
21 | $9 | $36 |
| Liver needle biopsy through skin A procedure in which a needle is inserted through the skin to remove a small sample of liver tissue for examination. |
20 | $66 | $384 |
| Injection, methylprednisolone acetate, 40 mg | 20 | $6 | $21 |
| CT scan of head/brain, without contrast A CT scan uses X-rays to create detailed images of the head or brain without the use of contrast dye. |
19 | $27 | $275 |
| Radiologist review of additional artery image A radiologist reviews an additional image of an artery. This step involves professional interpretation of the imaging data. |
19 | $37 | $370 |
| Fluoroscopic guidance for spine or back muscle injection This procedure uses real-time X-ray imaging to guide the placement of a needle for an injection into the spine or back muscles. |
19 | $21 | $114 |
| Arterial tube insertion, first branch A procedure to insert a tube into the first branch of an artery in the abdomen, pelvis, or leg. |
18 | $100 | $967 |
| Pelvis X-ray, 1-2 views An X-ray imaging test of the pelvic area using one to two different angles to visualize the bones and joints. |
18 | $6 | $35 |
| Stomach tube insertion with fluoroscopy and contrast A tube is placed into the stomach while using live X-ray imaging and a contrast dye to guide the procedure. |
16 | $159 | $1,650 |
| Knee X-ray, 3 views An X-ray imaging test of the knee joint that captures three different angles to evaluate the bones and surrounding structures. |
16 | $30 | $103 |
| New patient office visit (30-44 min) An initial office visit for a new patient lasting between 30 and 44 minutes. This code is used when the total time spent on the date of the encounter falls within this range. |
16 | $86 | $295 |
| X-ray of forearm, 2 views An X-ray imaging test of the forearm using two different angles to visualize the bones and surrounding structures. |
15 | $6 | $32 |
| Wrist X-ray, minimum 3 views An imaging test using X-rays to capture at least three different angles of the wrist bones and joints. |
15 | $5 | $35 |
| Ankle X-ray, minimum 3 views An X-ray imaging test of the ankle that captures at least three different angles to evaluate the bones and joints. |
15 | $5 | $35 |
| Injection into lower spine canal with imaging guidance A procedure where a substance is injected into the lower part of the spinal canal. The injection is performed using imaging guidance to ensure accurate placement. |
14 | $213 | $784 |
| Infusion tube insertion with imaging guidance A radiologist inserts an infusion tube into the body while using imaging guidance to ensure proper placement and reviews the procedure. |
13 | $66 | $757 |
| Balloon dilation of dialysis access with radiologist review A minimally invasive procedure to widen a narrowed section of a dialysis access vessel using a balloon catheter. The procedure includes review by a radiologist to ensure proper placement and effectiveness. |
13 | $112 | $1,160 |
| Vessel or growth occlusion with radiologist review A procedure to block blood flow to growths or obstructed vessels, including review by a radiologist. |
13 | $434 | $14,400 |
| Needle biopsy of abdominal cavity growth A needle is inserted into a growth within the abdominal cavity to remove a small tissue sample for laboratory analysis. |
13 | $60 | $350 |
| X-ray of upper arm, minimum of 2 views An X-ray imaging test of the upper arm that captures at least two different views to evaluate the bones and surrounding structures. |
13 | $4 | $35 |
| Elbow X-ray, minimum 3 views An X-ray imaging test of the elbow joint that captures at least three different angles to visualize the bones and surrounding structures. |
13 | $5 | $35 |
| Removal of central venous port or pump A procedure to remove a central venous access device, such as a port or pump, from the body. |
12 | $126 | $785 |
| Vena cava filter insertion with radiologist review A procedure to place a filter in the vena cava to prevent blood clots from traveling to the lungs, including review by a radiologist. |
12 | $170 | $5,500 |
| Bile duct injection for X-ray with imaging guidance A radiologist uses imaging guidance to inject dye into the bile duct through an existing skin access point for an X-ray examination. |
12 | $55 | $750 |
| CT-guided tissue removal A procedure using computed tomography imaging to guide the removal of tissue from the body. |
12 | $145 | $798 |
| Muscle needle biopsy A procedure in which a needle is used to remove a small sample of muscle tissue for laboratory examination. |
11 | $35 | $246 |
| Abdominal fluid drainage by tube with imaging guidance A procedure to remove fluid from the abdominal cavity using a tube. Imaging guidance is used to direct the placement of the tube. |
11 | $140 | $1,657 |
How to read this data: This reflects Medicare patients only (typically 65+). Payment amounts are what Medicare paid the provider, not your out-of-pocket cost. These counts do not measure clinical quality or years of experience.
1.4% high complexity
61.7% medium
37.0% routine
Industry Payment Transparency
Open Payments through 2024 ↗$2,558
Total received (2018-2024)
Avg $365/year across 7 years
Top 16% in CA for radiation oncology
A higher payment rank reflects disclosed industry relationships (consulting, research, speaking) common among subspecialists — not wrongdoing.
14
Companies
37
Payment records
Payments are publicly reported; disclosure does not establish legality · Not evidence of wrongdoing · How to interpret →
Payment categories are unavailable while the source breakdown is being rebuilt. Company and year totals do not identify how much belongs to each category.
Payment trend by year
Annual totals from pharmaceutical and medical device companies.
2024
$150
2023
$261
2022
$47
2021
$303
2020
$23
2019
$1,288
2018
$485
Payments by company (2024)
W. L. Gore & Associates, Inc.
$90
Medtronic, Inc.
$23
Boston Scientific Corporation
$21
Bard Peripheral Vascular, Inc.
$16
Top 3 companies account for 89.2% of 2024 payments
All-time payments by company (2018-2024) ›
W. L. Gore & Associates, Inc.
$1,152
Ethicon US, LLC
$561
Inari Medical, Inc.
$263
ARGON MEDICAL DEVICES, INC.
$116
Medtronic, Inc.
$97
Stryker Corporation
$82
Boston Scientific Corporation
$72
Terumo Medical Corporation
$50
BOSTON SCIENTIFIC CORPORATION
$42
Bard Peripheral Vascular, Inc.
$38
Sirtex Medical Inc
$30
Canon Medical Systems USA, Inc.
$25
Penumbra, Inc.
$17
AngioDynamics, Inc.
$13
Top 3 companies account for 77.3% of all-time payments
Associated products mentioned in payments ›
AZUR · Abre · CERTUS 140 MICROWAVE ABLATION SYSTEM · CLEANER · Conformable TAG Thoracic Endoprosthesis · EMBOLD Fibered · EXCLUDER Iliac Branch Endoprosthesis · FLOWTRIEVER CATHETER · GENERAL EMBOLICS · GORE VIABAHN Endoprosthesis with Heparin · General - Embolics · INTERLOCK · IVS - IVAS · IVS - VERTEBRAL AUGMENTATION PRODUCTS · Indigo System · KYPHON EXPRESS II KYPHOPAK TRAY · LUTONIX · LifeStream · NEUWAVE Flex Microwave Ablation System · OBSIDIO · OSTEOCOOL RF ABLATION SYSTEM · S · SIR-Spheres Microspheres · Smart Port CT · TAG Thoracic Endoprosthesis · TOSHIBA SCANNER · VIABAHN Endoprosthesis with Heparin Bioactive Surface · VIABAHN Endoprosthesis with PROPATEN Bioactive Surface · VIABAHN VBX Balloon Expandable Endoprosthesis · VIATORR TIPS Endoprosthesis w/ Controlled Expansion
Should you be concerned? Industry payments are disclosed through CMS Open Payments. Disclosure alone does not establish their purpose, legality, or effect on care. What matters is whether a recommended drug or device appears in your doctor's payment records. If so, consider asking your doctor about it. How to interpret this data →
Geographic Context
Radiation oncologists in nearby ZIP areas
65
County median income
$71,434
Nearest hospital to ZIP centroid (approximate)
SAINT AGNES MEDICAL CENTER
0.0 mi
0.0 mi
Data Sources
| Provider Registry | ✓ NPPES | NPPES snapshot; verify current record |
| Medicare Enrollment | ✓ PECOS | PECOS snapshot |
| Practice Data | ✓ Medicare Util. | Annual (CY lag) |
| Industry Payments | ✓ Open Payments | CY 2024 |
| Disciplinary History | — Not included | N/A |
This provider has data in 4 of 4 available federal datasets, with a Data Coverage level of Very High. This reflects how much public data is available about a provider. How we calculate this →
Summary
Dr. Speece is a mixed practice specialist, with above-average Medicare volume (top 23% in CA), with 20 years of NPI registration.
This summary is auto-generated from federal data, describing data availability and patterns. Read our methodology →
Frequently Asked Questions
Is Dr. Speece experienced with contrast dye for imaging (iodine-based)?
Based on Medicare claims data, Dr. Speece performed 2,967 contrast dye for imaging (iodine-based) services. These records cover Medicare fee-for-service activity, including eligible younger beneficiaries; they do not measure total practice volume or clinical quality.
Does Dr. Speece receive payments from pharmaceutical companies?
Yes. Dr. Speece received a total of $2,558 from 14 companies across 37 payment records. A record can group multiple payments. These transfers are publicly disclosed through CMS Open Payments. Disclosure alone does not establish their legality or effect on care. Patients may wish to ask their doctor about these relationships, especially if a recommended drug or device appears in the payment records.
How do Dr. Speece's costs compare to other radiation oncologists in Fresno?
Dr. Speece's average Medicare payment per service is $22. Note that these figures represent what Medicare pays, not your out-of-pocket cost, which depends on your specific insurance plan and deductible. Procedure-level data above shows both what was submitted and what Medicare paid for each service type.
What does Data Coverage mean?
Data Coverage (currently Very High for Dr. Speece) measures how much public federal data is available about a provider. It is not a quality rating. A "Very High" or "High" level means the provider has data across multiple federal sources (NPPES, PECOS, Medicare Utilization, Open Payments), indicating the presence of registry, enrollment, activity or payment records, not verified experience or clinical quality. A "Low" or "Moderate" level may simply mean the provider is newer, does not see Medicare patients, or has not received any industry payments — none of which are inherently negative. Read our full methodology →
Is this data up to date?
Source publication dates and the snapshots loaded on this site can differ. Rebuilding a page does not refresh its source records. Check the Medicare reporting year and the payment interval shown above; consult the linked official sources for newer releases and current registry details. See our data freshness policy →
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About this page
This page combines public CMS records with calculated summaries and explanatory procedure labels. These transformations are not verbatim federal records. Sources: NPPES ↗, Open Payments ↗, Medicare Provider Utilization ↗, and PECOS. Publication is mandated by the Physician Payments Sunshine Act (§6002 ACA, 42 U.S.C. §1320a-7h) and the Freedom of Information Act.
This page is not medical advice, an endorsement, a recommendation, or a quality rating. Data Coverage reflects data completeness — how much federal information exists for this provider — not clinical performance, patient outcomes, or quality of care. Always verify information directly with the provider and consult a licensed clinician before making medical decisions.
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