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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Providers
  3. Grace Makhlouf
⚕️
MDIndividual

Grace Makhlouf, M.D.

NPI: 1124073655
Sugar Land, TX
10 years of data
Rheumatology
$34.2M
Total Payments
226
Beneficiaries
1.9M
Services
3.31x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$34.2M
Specialty median$352.6K
Rank #29 of 32 in specialty

📋 Key Findings

1Billed $34.2M over 10 years
23.31x markup ratio (above median)
399th percentile in Rheumatology by payments
4743 services/day — physically implausible
5Payments surged 55% in 2015
614 procedures with >3x markup

⚠️ This provider averages 743 services per working day — physically unusual for an individual practitioner

Based on 1.9M total services over 10 years (250 working days/year). Learn about impossible service volumes →

🔎 Data Analysis

This provider's $34.2M in total Medicare payments ranks in the 99th percentile of Rheumatology providers nationally.

Averaging 743 services per working day raises questions about billing patterns.

Medicare payments to this provider grew 91% from 2014 to 2023.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

📈

Notable: Payments increased 55% in 2015

Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$95.72$24.943.84x$70.78$1.6M64.8K20
2015$69.58$19.123.64x$50.46$2.5M131.1K20
2016$62.22$18.423.38x$43.80$3.0M162.4K22
2017$61.27$19.553.13x$41.72$3.5M179.5K23
2018$59.22$19.703.01x$39.52$4.0M204.5K24
2019$59.48$19.753.01x$39.73$4.3M218.0K23
2020$58.99$20.242.91x$38.75$4.5M223.1K25
2021$55.66$17.443.19x$38.22$4.2M239.2K25
2022$56.85$15.053.78x$41.80$3.4M227.2K21
2023$58.53$14.983.91x$43.55$3.1M206.4K23

Top Procedures (20)

J0129Injection, 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)
$18.8M
527.6K services$35.64/svc2.23x markup
J1745Injection, infliximab, excludes biosimilar, 10 mg⚠ 3.6x markup
$5.9M
121.8K services$48.07/svc3.61x markup
J0717Injection, 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)⚠ 5.6x markup
$5.2M
977.2K services$5.37/svc5.59x markup
J1602Injection, golimumab, 1 mg, for intravenous use⚠ 5.1x markup
$2.2M
148.3K services$14.74/svc5.07x markup
96413Administration of chemotherapy into vein, 1 hour or less⚠ 5.9x markup
$859.3K
8.5K services$101.22/svc5.93x markup
99213Established patient office or other outpatient visit, 20-29 minutes
$292.2K
5.4K services$53.84/svc1.98x markup
96401Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle⚠ 3.9x markup
$280.4K
5.0K services$56.31/svc3.87x markup
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count
$75.7K
8.5K services$8.91/svc2.92x markup
86481Tuberculosis test, enumeration of t-cells⚠ 3.1x markup
$73.8K
757 services$97.44/svc3.08x markup
80076Liver function blood test panel⚠ 4.4x markup
$65.9K
8.3K services$7.89/svc4.43x markup
99214Established patient office or other outpatient visit, 30-39 minutes
$63.2K
967 services$65.34/svc2.37x markup
96365Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less⚠ 4.6x markup
$50.9K
1.0K services$49.56/svc4.64x markup
86140Measurement c-reactive protein for detection of infection or inflammation⚠ 4.9x markup
$50.9K
8.6K services$5.95/svc4.87x markup
96415Administration of chemotherapy into vein, each additional hour⚠ 9.3x markup
$47.8K
2.2K services$21.47/svc9.32x markup
82565Blood creatinine level⚠ 4.3x markup
$40.0K
8.2K services$4.87/svc4.31x markup
36415Insertion of needle into vein for collection of blood sample⚠ 3.2x markup
$30.0K
8.7K services$3.46/svc3.18x markup
85652Red blood cell sedimentation rate, to detect inflammation, automated⚠ 6.8x markup
$26.8K
8.6K services$3.10/svc6.77x markup
G0008Administration of influenza virus vaccine
$17.1K
773 services$22.18/svc2.10x markup
96372Injection of drug or substance under skin or into muscle⚠ 5.0x markup
$16.2K
1.1K services$14.12/svc4.96x markup
90688Influenza vaccine, quadrivalent, 0.5 ml dosage
$11.1K
625 services$17.78/svc2.20x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
J0129Injection, 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)527.6K$18.8M$35.642.23x
J1745Injection, infliximab, excludes biosimilar, 10 mg121.8K$5.9M$48.073.61x
J0717Injection, 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)977.2K$5.2M$5.375.59x
J1602Injection, golimumab, 1 mg, for intravenous use148.3K$2.2M$14.745.07x
96413Administration of chemotherapy into vein, 1 hour or less8.5K$859.3K$101.225.93x
99213Established patient office or other outpatient visit, 20-29 minutes5.4K$292.2K$53.841.98x
96401Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle5.0K$280.4K$56.313.87x
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count8.5K$75.7K$8.912.92x
86481Tuberculosis test, enumeration of t-cells757$73.8K$97.443.08x
80076Liver function blood test panel8.3K$65.9K$7.894.43x
99214Established patient office or other outpatient visit, 30-39 minutes967$63.2K$65.342.37x
96365Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less1.0K$50.9K$49.564.64x
86140Measurement c-reactive protein for detection of infection or inflammation8.6K$50.9K$5.954.87x
96415Administration of chemotherapy into vein, each additional hour2.2K$47.8K$21.479.32x
82565Blood creatinine level8.2K$40.0K$4.874.31x
36415Insertion of needle into vein for collection of blood sample8.7K$30.0K$3.463.18x
85652Red blood cell sedimentation rate, to detect inflammation, automated8.6K$26.8K$3.106.77x
G0008Administration of influenza virus vaccine773$17.1K$22.182.10x
96372Injection of drug or substance under skin or into muscle1.1K$16.2K$14.124.96x
90688Influenza vaccine, quadrivalent, 0.5 ml dosage625$11.1K$17.782.20x

Markup Analysis

Charge-to-Payment Ratio

3.31x

This provider submits charges 3.31 times higher than what Medicare actually pays.

What This Means

A markup ratio of 3.31x means for every $100 Medicare pays, this provider initially charges $331. This is higher than the national average.

Location

Sugar Land, TX

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

Similar Providers

Other Rheumatology providers in TX for peer comparison.

Grace Makhlouf (you)
$34.2M
Constantine Saadeh, M.D.
$39.3M
Show detailed table ▾
ProviderLocationTotal PaymentsStatus
Constantine Saadeh, M.D.Amarillo, TX$39.3M✓ Clear

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

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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