⚠️ This provider averages 1.0K services per working day — physically unusual for an individual practitioner
Based on 2.6M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $33.4M in total Medicare payments ranks in the 99th percentile of Rheumatology providers nationally.
Averaging 1.0K services per working day raises questions about billing patterns.
Medicare payments to this provider grew 54% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 82% in 2023
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 | $50.61 | $12.92 | 3.92x | $37.69 | $3.2M | 249.3K | 1.8K |
| 2015 | $25.55 | $12.92 | 1.98x | $12.63 | $2.3M | 180.1K | 1.3K |
| 2016 | $45.81 | $12.92 | 3.55x | $32.89 | $2.9M | 225.0K | 1.7K |
| 2017 | $45.63 | $12.92 | 3.53x | $32.71 | $2.4M | 187.2K | 1.4K |
| 2018 | $29.78 | $12.92 | 2.30x | $16.86 | $3.4M | 265.9K | 2.0K |
| 2019 | $48.81 | $12.92 | 3.78x | $35.89 | $3.6M | 280.3K | 2.1K |
| 2020 | $48.56 | $12.92 | 3.76x | $35.64 | $3.8M | 293.6K | 2.2K |
| 2021 | $39.13 | $12.92 | 3.03x | $26.21 | $3.9M | 305.1K | 2.3K |
| 2022 | $31.54 | $12.92 | 2.44x | $18.62 | $2.7M | 211.0K | 1.6K |
| 2023 | $21.61 | $12.92 | 1.67x | $8.69 | $5.0M | 384.2K | 2.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office/outpatient visit, low complexity | 1.2M | $10.7M | $9.24 | 2.24x |
| 99215 | Office/outpatient visit, high complexity | 414.4K | $3.6M | $8.65 | 2.14x |
| 99214 | Office/outpatient visit, moderate complexity | 351.9K | $3.4M | $9.66 | 2.06x |
| 36415 | Insertion of needle into vein for blood collection | 218.9K | $2.2M | $10.07 | 2.88x |
| 80053 | Comprehensive metabolic panel | 114.5K | $1.8M | $16.15 | 4.07x |
| 99203 | Office/outpatient visit, new patient | 129.2K | $1.4M | $11.15 | 2.11x |
| 85025 | Complete blood cell count | 155.2K | $1.4M | $8.88 | 3.93x |
| 71046 | Chest X-ray, 2 views | 89.4K | $1.1M | $11.91 | 4.00x |
| 93000 | Electrocardiogram with interpretation | 30.9K | $572.0K | $18.51 | 3.48x |
| 96372 | Therapeutic injection | 58.0K | $505.1K | $8.71 | 2.26x |
This provider submits charges 2 times higher than what Medicare actually pays.
A markup ratio of 2x means for every $100 Medicare pays, this provider initially charges $200. This is lower 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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