⚠️ This provider averages 990 services per working day — physically unusual for an individual practitioner
Based on 2.5M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $26.1M in total Medicare payments ranks in the 99th percentile of Rheumatology providers nationally.
Averaging 990 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 374% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 70% in 2015
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 | $85.70 | $36.86 | 2.33x | $48.84 | $701.9K | 19.0K | 20 |
| 2015 | $73.60 | $32.92 | 2.24x | $40.68 | $1.2M | 36.2K | 33 |
| 2016 | $51.43 | $21.13 | 2.43x | $30.30 | $1.6M | 73.4K | 39 |
| 2017 | $29.65 | $12.70 | 2.33x | $16.95 | $2.3M | 184.7K | 40 |
| 2018 | $31.97 | $12.20 | 2.62x | $19.77 | $3.0M | 249.6K | 39 |
| 2019 | $27.44 | $10.24 | 2.68x | $17.20 | $3.2M | 316.5K | 30 |
| 2020 | $27.04 | $10.58 | 2.56x | $16.46 | $3.6M | 339.4K | 35 |
| 2021 | $24.31 | $9.42 | 2.58x | $14.89 | $3.6M | 383.9K | 34 |
| 2022 | $23.64 | $7.91 | 2.99x | $15.73 | $3.4M | 435.3K | 33 |
| 2023 | $23.98 | $7.59 | 3.16x | $16.39 | $3.3M | 438.2K | 33 |
| 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) | 221.4K | $8.4M | $37.75 | 2.35x |
| 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) | 1.5M | $8.1M | $5.41 | 2.80x |
| J1602 | Injection, golimumab, 1 mg, for intravenous use | 140.1K | $2.3M | $16.15 | 2.79x |
| J3262 | Injection, tocilizumab, 1 mg | 482.5K | $2.0M | $4.24 | 2.40x |
| J9310 | Injection, rituximab, 100 mg | 2.0K | $1.2M | $607.61 | 1.85x |
| J9312 | Injection, rituximab, 10 mg | 14.2K | $987.1K | $69.40 | 2.53x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 12.4K | $949.8K | $76.79 | 3.03x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 4.0K | $394.1K | $99.37 | 5.03x |
| J1745 | Injection infliximab, 10 mg | 4.6K | $268.6K | $58.19 | 2.23x |
| J0897 | Injection, denosumab, 1 mg | 20.4K | $260.4K | $12.76 | 3.37x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 2.7K | $154.0K | $57.90 | 5.18x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 2.3K | $114.4K | $48.88 | 2.51x |
| 80053 | Blood test, comprehensive group of blood chemicals | 8.6K | $101.4K | $11.84 | 4.68x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 1.8K | $89.8K | $49.18 | 2.71x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 718 | $77.8K | $108.30 | 2.27x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 8.6K | $75.8K | $8.81 | 3.66x |
| 20610 | Aspiration and/or injection of fluid from large joint | 1.7K | $72.3K | $41.55 | 6.29x |
| 96372 | Injection of drug or substance under skin or into muscle | 5.4K | $65.8K | $12.11 | 2.93x |
| 73120 | X-ray of hand, 2 views | 2.8K | $53.6K | $18.86 | 4.46x |
| 86140 | Measurement c-reactive protein for detection of infection or inflammation | 7.8K | $45.3K | $5.84 | 5.13x |
This provider submits charges 2.67 times higher than what Medicare actually pays.
A markup ratio of 2.67x means for every $100 Medicare pays, this provider initially charges $267. 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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