This provider's $4.1M in total Medicare payments ranks in the 96th percentile of Rheumatology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
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 | $119.13 | $42.17 | 2.82x | $76.96 | $709.7K | 13.3K | 5.8K |
| 2015 | $104.59 | $39.42 | 2.65x | $65.17 | $600.0K | 11.8K | 5.1K |
| 2016 | $107.03 | $39.04 | 2.74x | $67.99 | $528.4K | 10.9K | 5.0K |
| 2017 | $143.77 | $65.34 | 2.20x | $78.43 | $492.4K | 9.7K | 4.8K |
| 2018 | $105.04 | $44.52 | 2.36x | $60.52 | $373.5K | 7.6K | 4.1K |
| 2019 | $105.22 | $38.41 | 2.74x | $66.81 | $324.5K | 7.0K | 3.8K |
| 2020 | $94.75 | $38.96 | 2.43x | $55.79 | $259.3K | 5.3K | 2.9K |
| 2021 | $90.65 | $40.86 | 2.22x | $49.79 | $303.7K | 5.1K | 2.9K |
| 2022 | $106.24 | $43.62 | 2.44x | $62.62 | $284.5K | 4.8K | 2.6K |
| 2023 | $110.59 | $44.49 | 2.49x | $66.10 | $230.8K | 4.1K | 2.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 17.4K | $1.0M | $59.20 | 1.96x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 5.4K | $611.1K | $113.25 | 1.77x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 10.6K | $593.0K | $56.17 | 2.62x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.2K | $357.4K | $84.52 | 2.37x |
| 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 5.4K | $299.1K | $55.62 | 4.50x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 6.1K | $237.8K | $39.05 | 2.44x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.0K | $153.0K | $77.15 | 2.04x |
| 77080 | Bone density measurement using dedicated X-ray machine | 3.2K | $151.2K | $47.56 | 3.15x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 953 | $114.8K | $120.43 | 1.66x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 6.7K | $104.2K | $15.49 | 3.23x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 677 | $75.9K | $112.18 | 1.78x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 1.2K | $74.1K | $61.05 | 2.46x |
| J7321 | Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose | 770 | $49.0K | $63.69 | 3.14x |
| 72010 | X-ray of entire spine | 673 | $41.5K | $61.60 | 2.44x |
| 20550 | Injections of tendon sheath, ligament, or muscle membrane | 938 | $40.7K | $43.42 | 2.30x |
| 72081 | X-ray of spine, 1 view | 1.3K | $36.6K | $28.42 | 5.28x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 344 | $19.7K | $57.33 | 2.62x |
| 73560 | X-ray of knee, 1 or 2 views | 620 | $15.5K | $24.97 | 3.00x |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 3.9K | $14.9K | $3.83 | 9.15x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 18 | $12.7K | $704.57 | 1.70x |
This provider submits charges 2.47 times higher than what Medicare actually pays.
A markup ratio of 2.47x means for every $100 Medicare pays, this provider initially charges $247. 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 CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Barry Eibschutz, M.D. | San Luis Obispo, CA | $55.8M | ✓ Clear |
| Shariar Cohen-Gadol, M.D. | Thousand Oaks, CA | $49.5M | ⚠️ Flagged |
| Gerald Ho, M.D. | La Palma, CA | $45.8M | ✓ Clear |
| Arash Horizon, M.D. | Los Angeles, CA | $45.0M | ✓ Clear |
| Daniel Watrous, M.D. | Visalia, CA | $41.6M | ✓ Clear |
Share this provider's Medicare payment information
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