This provider's $4.2M in total Medicare payments ranks in the 96th percentile of Rheumatology providers nationally.
Medicare payments to this provider grew 58% from 2014 to 2023.
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 | $201.50 | $51.33 | 3.93x | $150.17 | $273.3K | 4.1K | 1.7K |
| 2015 | $202.13 | $46.82 | 4.32x | $155.31 | $306.4K | 5.0K | 1.9K |
| 2016 | $242.68 | $60.00 | 4.04x | $182.68 | $324.9K | 4.9K | 1.9K |
| 2017 | $231.14 | $57.50 | 4.02x | $173.64 | $353.7K | 6.8K | 2.9K |
| 2018 | $202.70 | $51.76 | 3.92x | $150.94 | $451.7K | 9.5K | 4.2K |
| 2019 | $126.35 | $30.91 | 4.09x | $95.44 | $480.5K | 8.6K | 3.8K |
| 2020 | $154.31 | $40.10 | 3.85x | $114.21 | $531.8K | 7.6K | 2.6K |
| 2021 | $166.15 | $41.47 | 4.01x | $124.68 | $569.6K | 7.4K | 2.5K |
| 2022 | $166.50 | $40.73 | 4.09x | $125.77 | $507.8K | 7.2K | 2.5K |
| 2023 | $162.38 | $39.19 | 4.14x | $123.19 | $432.0K | 6.4K | 2.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 14.6K | $1.3M | $87.73 | 3.96x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 8.0K | $866.8K | $109.00 | 3.93x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 6.9K | $764.1K | $110.00 | 4.26x |
| 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) | 5.7K | $215.8K | $37.77 | 3.79x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 3.3K | $193.5K | $57.85 | 4.59x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 3.0K | $180.8K | $59.68 | 3.82x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.7K | $107.2K | $63.20 | 3.93x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 806 | $97.3K | $120.66 | 4.19x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 1.7K | $92.3K | $55.46 | 3.83x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 570 | $88.6K | $155.37 | 4.09x |
| J9310 | Injection, rituximab, 100 mg | 114 | $71.7K | $628.81 | 3.77x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 1.1K | $36.5K | $32.89 | 3.95x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 853 | $31.6K | $37.06 | 3.93x |
| 96374 | Injection of drug or substance into a vein for therapy, diagnosis, or prevention | 537 | $19.2K | $35.76 | 4.14x |
| 96415 | Infusion of chemotherapy into a vein | 810 | $19.0K | $23.51 | 3.79x |
| 80053 | Blood test, comprehensive group of blood chemicals | 1.3K | $17.1K | $12.74 | 3.38x |
| J0897 | Injection, denosumab, 1 mg | 1.0K | $15.0K | $14.58 | 3.69x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 89 | $14.4K | $161.30 | 3.70x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 103 | $12.5K | $121.55 | 3.73x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 350 | $8.6K | $24.65 | 3.77x |
This provider submits charges 4.02 times higher than what Medicare actually pays.
A markup ratio of 4.02x means for every $100 Medicare pays, this provider initially charges $402. 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 TX for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Constantine Saadeh, M.D. | Amarillo, TX | $39.3M | ✓ Clear |
| Grace Makhlouf, M.D. | Sugar Land, TX | $34.2M | ✓ Clear |
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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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