⚠️ This provider averages 509 services per working day — physically unusual for an individual practitioner
Based on 1.3M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $24.9M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Averaging 509 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 1618% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 805% in 2016
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 | $71.41 | $26.21 | 2.72x | $45.20 | $225.0K | 8.6K | 38 |
| 2015 | $77.85 | $27.19 | 2.86x | $50.66 | $204.1K | 7.5K | 34 |
| 2016 | $71.57 | $19.26 | 3.72x | $52.31 | $1.8M | 95.9K | 20 |
| 2017 | $107.77 | $27.69 | 3.89x | $80.08 | $2.3M | 81.9K | 18 |
| 2018 | $105.24 | $26.87 | 3.92x | $78.37 | $2.9M | 107.3K | 20 |
| 2019 | $68.91 | $17.43 | 3.95x | $51.48 | $2.4M | 140.4K | 19 |
| 2020 | $67.24 | $16.81 | 4.00x | $50.43 | $3.6M | 216.0K | 16 |
| 2021 | $74.45 | $18.34 | 4.06x | $56.11 | $3.6M | 198.0K | 17 |
| 2022 | $80.24 | $18.51 | 4.33x | $61.73 | $3.9M | 212.1K | 17 |
| 2023 | $85.41 | $18.80 | 4.54x | $66.61 | $3.9M | 205.6K | 21 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2357 | Injection, omalizumab, 5 mg | 143.5K | $4.0M | $28.06 | 3.15x |
| J1561 | Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg | 101.6K | $3.3M | $32.60 | 4.65x |
| J0517 | Injection, benralizumab, 1 mg | 18.2K | $2.4M | $133.23 | 3.89x |
| J3245 | Injection, tildrakizumab, 1 mg | 22.4K | $2.4M | $108.37 | 4.23x |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 45.6K | $2.3M | $50.15 | 5.53x |
| J3380 | Injection, vedolizumab, 1 mg | 133.5K | $2.1M | $15.42 | 4.44x |
| J0256 | Injection, alpha 1 proteinase inhibitor (human), not otherwise specified, 10 mg | 555.5K | $2.0M | $3.60 | 2.63x |
| J1569 | Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg | 50.4K | $1.6M | $32.74 | 5.14x |
| J2182 | Injection, mepolizumab, 1 mg | 47.9K | $1.1M | $22.78 | 3.22x |
| J1568 | Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg | 16.0K | $535.2K | $33.39 | 6.55x |
| J2323 | Injection, natalizumab, 1 mg | 36.6K | $533.1K | $14.56 | 2.45x |
| J0897 | Injection, denosumab, 1 mg | 26.7K | $392.4K | $14.70 | 5.07x |
| 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) | 7.3K | $270.3K | $36.90 | 2.95x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 4.6K | $232.0K | $49.98 | 3.89x |
| J3590 | Unclassified biologics | 63 | $211.7K | $3.4K | 3.55x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.3K | $210.8K | $64.52 | 2.40x |
| J2356 | Injection, tezepelumab-ekko, 1 mg | 14.5K | $206.5K | $14.25 | 4.14x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 2.0K | $190.6K | $95.94 | 2.22x |
| J3357 | Ustekinumab, for subcutaneous injection, 1 mg | 1.0K | $153.2K | $148.01 | 4.13x |
| J9312 | Injection, rituximab, 10 mg | 1.2K | $91.2K | $73.51 | 3.07x |
This provider submits charges 4.08 times higher than what Medicare actually pays.
A markup ratio of 4.08x means for every $100 Medicare pays, this provider initially charges $408. This is higher than the national average.
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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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