⚠️ This provider averages 448 services per working day — physically unusual for an individual practitioner
Based on 1.1M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $16.5M in total Medicare payments ranks in the 99th percentile of Rheumatology providers nationally.
Averaging 448 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 4504% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 465% in 2017
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 |
|---|---|---|---|---|---|---|---|
| 2014 | $66.87 | $25.77 | 2.59x | $41.10 | $81.1K | 3.1K | 11 |
| 2015 | $55.65 | $22.27 | 2.50x | $33.38 | $102.9K | 4.6K | 11 |
| 2016 | $128.03 | $36.73 | 3.49x | $91.30 | $176.1K | 4.8K | 13 |
| 2017 | $118.43 | $31.01 | 3.82x | $87.42 | $995.5K | 32.1K | 11 |
| 2018 | $122.08 | $31.64 | 3.86x | $90.44 | $1.2M | 39.0K | 9 |
| 2019 | $85.71 | $21.91 | 3.91x | $63.80 | $1.8M | 80.3K | 11 |
| 2020 | $77.82 | $20.53 | 3.79x | $57.29 | $2.7M | 131.6K | 13 |
| 2021 | $70.04 | $17.30 | 4.05x | $52.74 | $2.2M | 124.3K | 14 |
| 2022 | $42.13 | $11.15 | 3.78x | $30.98 | $3.6M | 323.3K | 18 |
| 2023 | $37.94 | $9.88 | 3.84x | $28.06 | $3.7M | 378.0K | 19 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 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) | 154.2K | $5.8M | $37.86 | 3.86x |
| J1602 | Injection, golimumab, 1 mg, for intravenous use | 208.5K | $2.8M | $13.35 | 4.03x |
| 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) | 302.8K | $1.6M | $5.17 | 4.13x |
| J3262 | Injection, tocilizumab, 1 mg | 269.4K | $1.3M | $4.67 | 3.85x |
| J0897 | Injection, denosumab, 1 mg | 70.4K | $1.1M | $15.47 | 3.71x |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 21.7K | $1.1M | $48.92 | 4.03x |
| J9312 | Injection, rituximab, 10 mg | 13.6K | $930.7K | $68.39 | 3.90x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 6.8K | $532.5K | $78.20 | 2.57x |
| J3111 | Injection, romosozumab-aqqg, 1 mg | 58.6K | $447.9K | $7.65 | 1.60x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 4.6K | $447.8K | $98.35 | 4.67x |
| J3357 | Ustekinumab, for subcutaneous injection, 1 mg | 1.7K | $254.2K | $148.64 | 3.85x |
| 96401 | Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle | 3.1K | $168.6K | $55.03 | 4.37x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 278 | $41.2K | $148.22 | 2.26x |
| 96415 | Administration of chemotherapy into vein, each additional hour | 1.1K | $23.1K | $21.63 | 4.54x |
| J3304 | Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg | 1.4K | $18.9K | $13.73 | 2.15x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 335 | $16.5K | $49.36 | 5.02x |
| 20610 | Aspiration and/or injection of fluid from large joint | 279 | $12.9K | $46.34 | 2.97x |
| 77080 | Bone density measurement using dedicated X-ray machine | 424 | $12.8K | $30.15 | 2.63x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 63 | $6.3K | $100.78 | 2.93x |
| 96372 | Injection of drug or substance under skin or into muscle | 540 | $6.2K | $11.50 | 3.78x |
This provider submits charges 3.84 times higher than what Medicare actually pays.
A markup ratio of 3.84x means for every $100 Medicare pays, this provider initially charges $384. 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 OK for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Craig Carson, M.D. | Edmond, OK | $72.8M | ✓ 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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