⚠️ This provider averages 788 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 $30.8M in total Medicare payments ranks in the 99th percentile of Rheumatology providers nationally.
Averaging 788 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 | $81.88 | $30.53 | 2.68x | $51.35 | $2.2M | 70.5K | 22 |
| 2015 | $84.38 | $34.01 | 2.48x | $50.37 | $2.5M | 72.1K | 19 |
| 2016 | $60.35 | $26.98 | 2.24x | $33.37 | $3.4M | 126.5K | 19 |
| 2017 | $48.56 | $21.61 | 2.25x | $26.95 | $3.8M | 175.0K | 21 |
| 2018 | $33.80 | $15.29 | 2.21x | $18.51 | $3.4M | 221.2K | 18 |
| 2019 | $24.08 | $12.84 | 1.88x | $11.24 | $3.0M | 235.1K | 22 |
| 2020 | $23.68 | $13.13 | 1.80x | $10.55 | $3.4M | 255.4K | 19 |
| 2021 | $23.44 | $11.56 | 2.03x | $11.88 | $3.2M | 280.6K | 19 |
| 2022 | $25.11 | $11.14 | 2.25x | $13.97 | $2.9M | 259.9K | 22 |
| 2023 | $27.17 | $11.44 | 2.38x | $15.73 | $3.1M | 274.3K | 21 |
| 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) | 219.2K | $7.0M | $32.09 | 2.06x |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 122.3K | $7.0M | $57.17 | 2.54x |
| 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) | 909.0K | $4.9M | $5.40 | 1.85x |
| J1602 | Injection, golimumab, 1 mg, for intravenous use | 141.3K | $2.1M | $14.91 | 2.01x |
| J0897 | Injection, denosumab, 1 mg | 138.1K | $2.1M | $15.17 | 1.67x |
| Q5104 | Injection, infliximab-abda, biosimilar, (renflexis), 10 mg | 53.7K | $2.0M | $37.29 | 2.28x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 17.6K | $1.0M | $59.31 | 1.65x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 8.9K | $972.7K | $109.48 | 3.40x |
| J3262 | Injection, tocilizumab, 1 mg | 277.3K | $970.0K | $3.50 | 3.73x |
| J9310 | Injection, rituximab, 100 mg | 960 | $605.4K | $630.62 | 1.59x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 4.8K | $426.3K | $88.12 | 1.53x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 3.2K | $418.8K | $129.09 | 1.70x |
| J7325 | Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg | 44.2K | $412.3K | $9.32 | 2.68x |
| 96401 | Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle | 4.8K | $307.7K | $63.79 | 1.41x |
| 20610 | Aspiration and/or injection of fluid from large joint | 3.9K | $230.1K | $59.00 | 2.26x |
| 96415 | Administration of chemotherapy into vein, each additional hour | 5.3K | $123.2K | $23.29 | 3.08x |
| 96372 | Injection of drug or substance under skin or into muscle | 2.4K | $34.3K | $14.04 | 6.41x |
| 20553 | Injection of trigger points, 3 or more muscles | 701 | $32.9K | $46.99 | 1.81x |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 5.9K | $23.2K | $3.94 | 3.81x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 154 | $17.0K | $110.51 | 3.17x |
This provider submits charges 2.2 times higher than what Medicare actually pays.
A markup ratio of 2.2x means for every $100 Medicare pays, this provider initially charges $220. 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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