Medicare Enrolled
Dr. Paul Speece, M.D.
Radiation Oncology · Fresno, CA
Practice pattern: Mixed Practice
— Diverse clinical practice across multiple procedure types
Low-engagement
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 6,854 Medicare services across 2,672 unique beneficiaries.
Between the years covered by Open Payments, Dr. Speece received a total of $2,558 from 14 pharmaceutical and/or device companies across 37 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common in radiation oncology. Most payments are for meals and travel — low-value interactions common across virtually all practicing physicians. 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 in practice
▲ Top 24% volume in CA
$2,558 industry payments
Medicare Practice Summary
Medicare Utilization ↗6,854
Medicare services
Top 24% in CA for radiation oncology
2,672
Unique beneficiaries
$23
Avg. Medicare payment
Medicare patients only (65+ / disabled) · How to read this →
~343 Medicare services per year of practice
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 |
| 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 |
| 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 |
| 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. |
87 | $22 | $107 |
| Abdominal X-ray, 1 view An X-ray image of the abdomen taken from a single angle to visualize internal structures. |
62 | $7 | $37 |
| Radiologist review of CT-guided needle placement A radiologist reviews the CT imaging used to guide the placement of a needle. |
57 | $55 | $275 |
| 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 |
| 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 |
| 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 |
| 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. |
38 | $42 | $166 |
| Ultrasound guidance for needle placement Use of ultrasound imaging to guide the precise placement of a needle during a medical procedure. |
36 | $23 | $134 |
| 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 |
| 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 |
| 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. |
23 | $32 | $125 |
| 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 |
| 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. |
19 | $22 | $111 |
| 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 |
| Knee X-ray, 4 or more views An imaging test using X-rays to create multiple pictures of the knee joint from different angles. |
18 | $36 | $108 |
| 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. |
17 | $26 | $95 |
| Fluoroscopic guidance for needle placement Use of real-time X-ray imaging to guide the precise placement of a needle during a medical procedure. |
17 | $100 | $246 |
| 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 |
| 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. |
16 | $145 | $1,803 |
| 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. |
16 | $28 | $108 |
| 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 |
| 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. |
16 | $86 | $223 |
| 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 |
| 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. |
13 | $774 | $4,241 |
| 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 |
| 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. |
12 | $22 | $87 |
| 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. |
12 | $33 | $200 |
| 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. A higher procedure volume generally indicates more experience with that procedure.
1.6% high complexity
70.1% medium
28.3% 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
Individual payments
All payments are legal and publicly reported · Not evidence of wrongdoing · How to interpret →
Payment profile
Industry payments classified by relationship type. Not all payments are equal — research and consulting reflect different relationships than speaking programs or meals.
Meals & Travel
Food, beverages, travel, and lodging — typically low-value
$2,108 (82.4%)
Consulting
Expert advisory fees, typically reflecting recognized clinical expertise
$450 (17.6%)
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)
Consulting
Speaking
Meals & Travel
Research
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? Payments from pharmaceutical and device companies are legal and common — 57% of U.S. physicians receive at least one. They often reflect legitimate consulting, research, or education. 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 →
Most payments (82%) are for meals and travel — low-value interactions that are common across virtually all practicing physicians.
Geographic Context
Radiation oncologists within 10 mi
65
Per 100K population
6.4
County median income
$71,434
Nearest hospital
SAINT AGNES MEDICAL CENTER
0.0 mi
0.0 mi
Data Sources
| Provider Registry | ✓ NPPES | Weekly updates |
| Medicare Enrollment | ✓ PECOS | Monthly updates |
| Practice Data | ✓ Medicare Util. | Annual (CY lag) |
| Industry Payments | ✓ Open Payments | CY 2024 |
| Disciplinary History | — Not public | 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 24% in CA), with low-engagement industry engagement in the top 16% of CA peers, 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. Research suggests that higher procedure volume is often associated with better outcomes, particularly for complex procedures. Note that Medicare data only captures patients aged 65 and older, so the total practice volume across all patients is likely higher.
Does Dr. Speece receive payments from pharmaceutical companies?
Yes. Dr. Speece received a total of $2,558 from 14 companies across 37 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common among physicians — 57% of all U.S. physicians receive at least one industry payment. 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 $23. 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 a long track record of practice, Medicare participation, and industry disclosure. 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?
Each data source has its own update cycle. Provider registry data (NPPES) is updated weekly. Medicare enrollment (PECOS) is updated monthly. Medicare practice data has a ~2 year lag — the most recent available is typically 2 years prior. Industry payment data (Open Payments) is published annually, usually in June, covering the prior calendar year. We display the data date prominently on each section so you always know how current it is. See our data freshness policy →
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About this page
All data on this page is sourced verbatim from public federal records published by the U.S. Centers for Medicare & Medicaid Services (CMS): 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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