⚠️ This provider averages 1.5K services per working day — physically unusual for an individual practitioner
Based on 3.8M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $42.4M in total Medicare payments ranks in the 99th percentile of Rheumatology providers nationally.
Averaging 1.5K services per working day raises questions about billing patterns.
Medicare payments to this provider grew 7098% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 289% in 2017
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 | $87.51 | $23.78 | 3.68x | $63.73 | $111.5K | 4.7K | 9 |
| 2015 | $90.66 | $23.85 | 3.80x | $66.81 | $176.6K | 7.4K | 12 |
| 2016 | $27.53 | $8.80 | 3.13x | $18.73 | $428.2K | 48.7K | 12 |
| 2017 | $25.29 | $8.97 | 2.82x | $16.32 | $1.7M | 185.7K | 11 |
| 2018 | $36.59 | $13.61 | 2.69x | $22.98 | $3.5M | 258.9K | 14 |
| 2019 | $42.69 | $15.59 | 2.74x | $27.10 | $5.3M | 339.2K | 18 |
| 2020 | $39.65 | $13.98 | 2.84x | $25.67 | $6.9M | 492.1K | 20 |
| 2021 | $35.81 | $11.64 | 3.08x | $24.17 | $8.0M | 685.2K | 21 |
| 2022 | $36.26 | $9.98 | 3.63x | $26.28 | $8.3M | 829.6K | 25 |
| 2023 | $31.61 | $8.89 | 3.56x | $22.72 | $8.0M | 902.2K | 22 |
| 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) | 376.2K | $14.6M | $38.77 | 2.56x |
| 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) | 2.4M | $13.0M | $5.30 | 3.01x |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 82.5K | $2.7M | $32.78 | 5.22x |
| Q5104 | Injection, infliximab-abda, biosimilar, (renflexis), 10 mg | 52.6K | $2.0M | $37.35 | 5.05x |
| J3262 | Injection, tocilizumab, 1 mg | 378.7K | $1.7M | $4.57 | 2.19x |
| J1602 | Injection, golimumab, 1 mg, for intravenous use | 137.2K | $1.6M | $11.89 | 5.05x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 16.1K | $1.5M | $92.24 | 3.12x |
| J0897 | Injection, denosumab, 1 mg | 92.3K | $1.5M | $15.82 | 2.49x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 8.6K | $1.0M | $116.65 | 3.17x |
| 96401 | Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle | 14.5K | $969.0K | $66.61 | 3.06x |
| J3111 | Injection, romosozumab-aqqg, 1 mg | 75.6K | $570.8K | $7.55 | 3.31x |
| J7320 | Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg | 23.1K | $297.9K | $12.88 | 2.48x |
| 20610 | Aspiration and/or injection of fluid from large joint | 4.2K | $218.1K | $52.25 | 3.76x |
| Q5121 | Injection, infliximab-axxq, biosimilar, (avsola), 10 mg | 6.3K | $207.4K | $33.13 | 6.04x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.5K | $196.7K | $130.95 | 3.37x |
| J7329 | Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg | 9.9K | $73.4K | $7.41 | 4.32x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1.2K | $73.4K | $62.08 | 3.15x |
| 96415 | Administration of chemotherapy into vein, each additional hour | 2.5K | $62.6K | $24.95 | 4.05x |
| J7321 | Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose | 745 | $49.7K | $66.68 | 3.30x |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 18.3K | $20.9K | $1.14 | 8.29x |
This provider submits charges 3.16 times higher than what Medicare actually pays.
A markup ratio of 3.16x means for every $100 Medicare pays, this provider initially charges $316. 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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