This provider averages 78 services per working day
Based on 194.2K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $5.3M in total Medicare payments ranks in the 97th percentile of Rheumatology providers nationally.
Averaging 78 services per working day raises questions about billing patterns.
AI-generated analysis based on Medicare payment data.
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 |
|---|---|---|---|---|---|---|---|
| 2014 | $118.64 | $36.63 | 3.24x | $82.01 | $569.1K | 20.8K | 8.4K |
| 2015 | $121.70 | $37.21 | 3.27x | $84.49 | $593.0K | 21.3K | 9.0K |
| 2016 | $125.31 | $38.07 | 3.29x | $87.24 | $595.1K | 21.6K | 9.6K |
| 2017 | $200.45 | $64.33 | 3.12x | $136.12 | $555.7K | 19.7K | 8.9K |
| 2018 | $192.12 | $58.92 | 3.26x | $133.20 | $480.4K | 18.0K | 7.6K |
| 2019 | $136.49 | $34.98 | 3.90x | $101.51 | $455.5K | 17.8K | 7.3K |
| 2020 | $141.71 | $36.40 | 3.89x | $105.31 | $449.6K | 17.5K | 8.3K |
| 2021 | $136.72 | $35.98 | 3.80x | $100.74 | $487.2K | 17.8K | 7.9K |
| 2022 | $164.24 | $43.06 | 3.81x | $121.18 | $551.0K | 21.0K | 9.6K |
| 2023 | $177.23 | $44.21 | 4.01x | $133.02 | $589.2K | 18.7K | 8.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 18.6K | $1.7M | $92.36 | 2.83x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 3.3K | $377.9K | $115.00 | 4.65x |
| 82306 | Vitamin D-3 level | 10.4K | $360.4K | $34.72 | 2.50x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 4.8K | $351.2K | $73.46 | 4.15x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.4K | $230.2K | $66.91 | 2.99x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 1.2K | $205.1K | $167.46 | 2.99x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 3.2K | $197.8K | $62.43 | 4.79x |
| 83970 | Parathormone (parathyroid hormone) level | 4.0K | $189.5K | $47.39 | 2.61x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 1.5K | $179.0K | $120.16 | 4.47x |
| 80053 | Blood test, comprehensive group of blood chemicals | 13.2K | $126.5K | $9.58 | 8.95x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 12.7K | $115.1K | $9.03 | 5.31x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 1.4K | $93.2K | $67.59 | 3.70x |
| 86140 | Measurement C-reactive protein for detection of infection or inflammation | 14.6K | $88.4K | $6.05 | 2.63x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 675 | $86.5K | $128.09 | 2.46x |
| 82550 | Creatine kinase (cardiac enzyme) level | 12.7K | $68.8K | $5.41 | 7.86x |
| 85651 | Red blood cell sedimentation rate, to detect inflammation | 14.9K | $65.9K | $4.43 | 8.57x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 4.4K | $65.7K | $14.91 | 4.02x |
| J0129 | Injection, abatacept, 10 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) | 1.6K | $57.0K | $36.78 | 2.70x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 92 | $55.3K | $601.26 | 2.33x |
| 36415 | Insertion of needle into vein for collection of blood sample | 16.2K | $54.3K | $3.36 | 4.46x |
This provider submits charges 3.8 times higher than what Medicare actually pays.
A markup ratio of 3.8x means for every $100 Medicare pays, this provider initially charges $380. 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 CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Barry Eibschutz, M.D. | San Luis Obispo, CA | $55.8M | ✓ Clear |
| Shariar Cohen-Gadol, M.D. | Thousand Oaks, CA | $49.5M | ⚠️ Flagged |
| Gerald Ho, M.D. | La Palma, CA | $45.8M | ✓ Clear |
| Arash Horizon, M.D. | Los Angeles, CA | $45.0M | ✓ Clear |
| Daniel Watrous, M.D. | Visalia, CA | $41.6M | ✓ 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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