⚠️ This provider averages 817 services per working day — physically unusual for an individual practitioner
Based on 2.0M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $30.4M in total Medicare payments ranks in the 99th percentile of Rheumatology providers nationally.
Averaging 817 services per working day raises questions about billing patterns.
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 | $52.11 | $21.63 | 2.41x | $30.48 | $2.2M | 100.0K | 25 |
| 2015 | $56.73 | $22.77 | 2.49x | $33.96 | $2.7M | 119.3K | 23 |
| 2016 | $55.91 | $22.16 | 2.52x | $33.75 | $3.0M | 133.4K | 25 |
| 2017 | $38.52 | $16.11 | 2.39x | $22.41 | $3.1M | 194.4K | 19 |
| 2018 | $39.82 | $16.91 | 2.35x | $22.91 | $3.2M | 186.9K | 25 |
| 2019 | $34.08 | $13.47 | 2.53x | $20.61 | $3.2M | 236.7K | 22 |
| 2020 | $38.09 | $14.80 | 2.57x | $23.29 | $3.4M | 227.7K | 23 |
| 2021 | $35.75 | $13.32 | 2.68x | $22.43 | $3.4M | 256.3K | 20 |
| 2022 | $33.01 | $11.31 | 2.92x | $21.70 | $3.1M | 269.7K | 22 |
| 2023 | $28.78 | $10.10 | 2.85x | $18.68 | $3.2M | 318.7K | 26 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 157.7K | $7.9M | $50.38 | 3.05x |
| 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) | 1.0M | $5.6M | $5.39 | 2.40x |
| 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) | 153.6K | $5.2M | $34.11 | 2.14x |
| J0897 | Injection, denosumab, 1 mg | 174.0K | $2.6M | $14.84 | 1.99x |
| J9312 | Injection, rituximab, 10 mg | 28.4K | $1.9M | $66.65 | 3.13x |
| J9310 | Injection, rituximab, 100 mg | 2.2K | $1.3M | $596.12 | 2.40x |
| J3111 | Injection, romosozumab-aqqg, 1 mg | 179.8K | $1.3M | $7.29 | 1.59x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 10.2K | $866.8K | $84.69 | 2.91x |
| J3262 | Injection, tocilizumab, 1 mg | 228.9K | $866.5K | $3.79 | 2.07x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 7.2K | $806.9K | $112.45 | 2.85x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 14.0K | $776.1K | $55.44 | 2.99x |
| 96401 | Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle | 5.2K | $329.7K | $63.56 | 2.83x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.2K | $146.2K | $123.91 | 2.98x |
| 96415 | Administration of chemotherapy into vein, each additional hour | 5.4K | $127.0K | $23.60 | 3.61x |
| 20610 | Aspiration and/or injection of fluid from large joint | 2.2K | $106.1K | $48.68 | 3.25x |
| J1306 | Injection, inclisiran, 1 mg | 10.2K | $90.8K | $8.88 | 2.43x |
| 96372 | Injection of drug or substance under skin or into muscle | 3.9K | $54.6K | $14.14 | 4.34x |
| 73218 | MRI scan of arm | 284 | $53.2K | $187.33 | 3.21x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 247 | $33.5K | $135.79 | 2.68x |
| 77080 | Bone density measurement using dedicated x-ray machine | 645 | $27.8K | $43.10 | 2.17x |
This provider submits charges 2.58 times higher than what Medicare actually pays.
A markup ratio of 2.58x means for every $100 Medicare pays, this provider initially charges $258. 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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