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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. Elena Flagg
⚕️
MDIndividual

Elena Flagg, M.D.

NPI: 1174580310
Williamsburg, VA
10 years of data
Rheumatology
$42.6M
Total Payments
336
Beneficiaries
2.4M
Services
2.06x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$42.6M
Specialty median$352.6K
Rank #13 of 32 in specialty

📋 Key Findings

1Billed $42.6M over 10 years
22.06x markup ratio (above median)
399th percentile in Rheumatology by payments
4974 services/day — physically implausible
56 procedures with >3x markup

⚠️ This provider averages 974 services per working day — physically unusual for an individual practitioner

Based on 2.4M total services over 10 years (250 working days/year). Learn about impossible service volumes →

🔎 Data Analysis

This provider's $42.6M in total Medicare payments ranks in the 99th percentile of Rheumatology providers nationally.

Averaging 974 services per working day raises questions about billing patterns.

Medicare payments to this provider grew 72% 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

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$70.45$33.302.12x$37.15$2.2M65.5K34
2015$46.82$24.171.94x$22.65$3.2M132.1K35
2016$38.78$20.531.89x$18.25$4.0M195.8K34
2017$42.39$22.351.90x$20.04$4.4M197.1K38
2018$38.73$20.611.88x$18.12$5.2M254.5K38
2019$36.12$17.972.01x$18.15$6.7M371.5K40
2020$31.61$15.522.04x$16.09$4.5M290.1K31
2021$29.13$13.232.20x$15.90$4.5M341.7K29
2022$32.07$13.332.41x$18.74$4.1M310.3K30
2023$31.72$13.602.33x$18.12$3.8M276.1K27

Top Procedures (20)

J1745Injection, infliximab, excludes biosimilar, 10 mg
$13.1M
260.4K services$50.38/svc2.15x markup
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)
$11.8M
325.8K services$36.32/svc1.60x 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)
$3.6M
650.6K services$5.50/svc2.09x markup
J0897Injection, denosumab, 1 mg
$3.5M
236.7K services$14.61/svc1.70x markup
J3262Injection, tocilizumab, 1 mg
$3.1M
779.6K services$3.92/svc2.07x markup
99214Established patient office or other outpatient visit, 30-39 minutes
$1.2M
15.2K services$81.32/svc2.28x markup
96413Administration of chemotherapy into vein, 1 hour or less⚠ 5.4x markup
$1.1M
10.1K services$108.02/svc5.36x markup
J9310Injection, rituximab, 100 mg
$1.1M
1.6K services$639.57/svc1.37x markup
J3245Injection, tildrakizumab, 1 mg
$1.0M
9.5K services$108.92/svc1.60x markup
J9312Injection, rituximab, 10 mg
$738.2K
9.9K services$74.34/svc1.55x markup
J1602Injection, golimumab, 1 mg, for intravenous use
$623.7K
45.3K services$13.78/svc2.19x markup
96401Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle
$216.7K
3.7K services$58.94/svc2.65x markup
96372Injection of drug or substance under skin or into muscle
$193.2K
13.6K services$14.18/svc2.96x markup
99213Established patient office or other outpatient visit, 20-29 minutes
$180.1K
3.4K services$52.56/svc2.41x markup
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count⚠ 4.5x markup
$161.4K
17.9K services$9.02/svc4.55x markup
20610Aspiration and/or injection of fluid from large joint⚠ 4.2x markup
$134.6K
3.0K services$45.08/svc4.24x markup
77080Dxa bone density measurement of hip, pelvis, spine⚠ 4.9x markup
$131.0K
3.2K services$40.47/svc4.94x markup
96415Administration of chemotherapy into vein, each additional hour⚠ 7.6x markup
$126.2K
5.5K services$23.08/svc7.58x markup
99204New patient office or other outpatient visit, 45-59 minutes
$99.1K
816 services$121.40/svc2.32x markup
J7321Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose⚠ 4.2x markup
$80.1K
1.2K services$65.15/svc4.22x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
J1745Injection, infliximab, excludes biosimilar, 10 mg260.4K$13.1M$50.382.15x
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)325.8K$11.8M$36.321.60x
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)650.6K$3.6M$5.502.09x
J0897Injection, denosumab, 1 mg236.7K$3.5M$14.611.70x
J3262Injection, tocilizumab, 1 mg779.6K$3.1M$3.922.07x
99214Established patient office or other outpatient visit, 30-39 minutes15.2K$1.2M$81.322.28x
96413Administration of chemotherapy into vein, 1 hour or less10.1K$1.1M$108.025.36x
J9310Injection, rituximab, 100 mg1.6K$1.1M$639.571.37x
J3245Injection, tildrakizumab, 1 mg9.5K$1.0M$108.921.60x
J9312Injection, rituximab, 10 mg9.9K$738.2K$74.341.55x
J1602Injection, golimumab, 1 mg, for intravenous use45.3K$623.7K$13.782.19x
96401Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle3.7K$216.7K$58.942.65x
96372Injection of drug or substance under skin or into muscle13.6K$193.2K$14.182.96x
99213Established patient office or other outpatient visit, 20-29 minutes3.4K$180.1K$52.562.41x
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count17.9K$161.4K$9.024.55x
20610Aspiration and/or injection of fluid from large joint3.0K$134.6K$45.084.24x
77080Dxa bone density measurement of hip, pelvis, spine3.2K$131.0K$40.474.94x
96415Administration of chemotherapy into vein, each additional hour5.5K$126.2K$23.087.58x
99204New patient office or other outpatient visit, 45-59 minutes816$99.1K$121.402.32x
J7321Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose1.2K$80.1K$65.154.22x

Markup Analysis

Charge-to-Payment Ratio

2.06x

This provider submits charges 2.06 times higher than what Medicare actually pays.

What This Means

A markup ratio of 2.06x means for every $100 Medicare pays, this provider initially charges $206. This is higher than the national average.

Location

Williamsburg, VA

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 VA for peer comparison.

Elena Flagg (you)
$42.6M
Michael Strachan, M.D.
$36.6M
Show detailed table ▾
ProviderLocationTotal PaymentsStatus
Michael Strachan, M.D.Richmond, VA$36.6M✓ 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.

Believe this data is inaccurate? Dispute this data