⚠️ This provider averages 2.3K services per working day — physically unusual for an individual practitioner
Based on 3.9M total services over 7 years (250 working days/year). Learn about impossible service volumes →
This provider's $22.6M in total Medicare payments ranks in the 99th percentile of Rheumatology providers nationally.
Averaging 2.3K services per working day raises questions about billing patterns.
Medicare payments to this provider grew 14634% from 2017 to 2023.
88% of their billing comes from a single procedure code (J0717 — Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 3068% in 2018
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 |
|---|---|---|---|---|---|---|---|
| 2017 | $159.95 | $51.03 | 3.13x | $108.92 | $31.3K | 614 | 6 |
| 2018 | $17.09 | $7.51 | 2.28x | $9.58 | $992.7K | 132.2K | 10 |
| 2019 | $15.10 | $6.89 | 2.19x | $8.21 | $2.6M | 381.6K | 9 |
| 2020 | $14.66 | $6.98 | 2.10x | $7.68 | $4.5M | 640.0K | 8 |
| 2021 | $14.51 | $6.27 | 2.31x | $8.24 | $5.2M | 826.9K | 7 |
| 2022 | $14.41 | $5.02 | 2.87x | $9.39 | $4.7M | 938.6K | 10 |
| 2023 | $14.38 | $4.50 | 3.20x | $9.88 | $4.6M | 1.0M | 8 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0717 | Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) | 3.8M | $19.8M | $5.16 | 2.52x |
| 96401 | Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle | 19.3K | $1.2M | $59.73 | 3.16x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 6.0K | $540.3K | $89.48 | 3.02x |
| J0897 | Injection, denosumab, 1 mg | 32.6K | $531.2K | $16.31 | 2.15x |
| J3111 | Injection, romosozumab-aqqg, 1 mg | 40.1K | $313.6K | $7.82 | 1.49x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 1.2K | $185.1K | $157.92 | 3.26x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 275 | $31.3K | $113.69 | 3.65x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 152 | $16.2K | $106.70 | 3.40x |
| 20610 | Aspiration and/or injection of fluid from large joint | 355 | $14.3K | $40.40 | 4.31x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 84 | $4.6K | $54.41 | 3.38x |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 2.6K | $3.1K | $1.19 | 12.59x |
| 96372 | Injection of drug or substance under skin or into muscle | 200 | $2.2K | $10.91 | 7.64x |
| 20553 | Injections of trigger points in 3 or more muscles | 39 | $2.0K | $51.10 | 4.31x |
| 20600 | Aspiration and/or injection of small joint or joint capsule | 52 | $1.7K | $31.86 | 4.24x |
| 20605 | Aspiration and/or injection of medium joint or joint capsule | 37 | $1.2K | $33.65 | 4.31x |
This provider submits charges 2.55 times higher than what Medicare actually pays.
A markup ratio of 2.55x means for every $100 Medicare pays, this provider initially charges $255. 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.
Other Rheumatology providers in FL for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Aymen Kenawy, M.D. | Lynn Haven, FL | $56.3M | ✓ Clear |
| Vipul Joshi, MD | Brandon, FL | $41.8M | ✓ Clear |
| Adam Rosen, MD | Clearwater, FL | $38.6M | ✓ Clear |
| Eugenia Rullan Bidot, MD | Clearwater, FL | $38.2M | ✓ Clear |
| Marc Hirsh, M.D. | Delray Beach, FL | $33.8M | ✓ Clear |
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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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