Statistical flag only — not an accusation of fraud
⚠️ This provider averages 1.2K services per working day — physically unusual for an individual practitioner
Based on 1.5M total services over 5 years (250 working days/year). Learn about impossible service volumes →
This provider's $24.7M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Averaging 1.2K services per working day raises questions about billing patterns.
Medicare payments to this provider grew 72% from 2019 to 2023.
This provider has been statistically flagged with a risk score of 83/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 68% in 2020
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 |
|---|---|---|---|---|---|---|---|
| 2019 | $46.23 | $17.32 | 2.67x | $28.91 | $3.0M | 174.7K | 11 |
| 2020 | $50.86 | $18.81 | 2.70x | $32.05 | $5.1M | 270.8K | 15 |
| 2021 | $53.07 | $19.20 | 2.76x | $33.87 | $6.4M | 335.1K | 17 |
| 2022 | $59.48 | $17.10 | 3.48x | $42.38 | $4.9M | 286.0K | 16 |
| 2023 | $50.85 | $11.39 | 4.46x | $39.46 | $5.2M | 456.9K | 16 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J7320 | Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg | 1.1M | $11.6M | $10.41 | 1.92x |
| 77002 | Fluoroscopic guidance for needle placement | 47.4K | $4.5M | $94.22 | 4.46x |
| 20610 | Aspiration and/or injection of fluid from large joint | 47.5K | $3.3M | $68.94 | 4.91x |
| J7332 | Hyaluronan or derivative, triluron, for intra-articular injection, 1 mg | 96.5K | $1.8M | $18.46 | 1.63x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 9.3K | $627.4K | $67.18 | 2.68x |
| J7321 | Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose | 10.4K | $616.8K | $59.31 | 4.50x |
| 27369 | Injection of contrast for imaging of knee joint | 2.9K | $505.2K | $175.10 | 6.16x |
| 73580 | Review by radiologist of knee joint image | 4.1K | $481.4K | $117.08 | 3.59x |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 7.3K | $286.0K | $39.26 | 3.95x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 2.3K | $272.8K | $118.18 | 5.08x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 2.3K | $243.7K | $104.62 | 4.38x |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 2.8K | $222.6K | $78.31 | 4.50x |
| J1020 | Injection, methylprednisolone acetate, 20 mg | 57.2K | $192.3K | $3.36 | 8.92x |
| J7328 | Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg | 42.2K | $36.0K | $0.85 | 5.86x |
| 23350 | Injection of contrast for imaging of shoulder joint | 206 | $32.4K | $157.08 | 6.56x |
| 73040 | Review by radiologist of shoulder joint image | 229 | $24.6K | $107.50 | 3.91x |
| J7325 | Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg | 1.0K | $8.1K | $8.05 | 27.73x |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 78.5K | $8.0K | $0.10 | 295.09x |
| 99202 | New patient office or other outpatient visit, 15-29 minutes | 105 | $5.1K | $48.74 | 6.10x |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 150 | $17.92 | $0.12 | 167.41x |
This provider submits charges 3.24 times higher than what Medicare actually pays.
A markup ratio of 3.24x means for every $100 Medicare pays, this provider initially charges $324. 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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