⚠️ This provider averages 254 services per working day — physically unusual for an individual practitioner
Based on 571.9K total services over 9 years (250 working days/year). Learn about impossible service volumes →
This provider's $12.4M in total Medicare payments ranks in the 99th percentile of Rheumatology providers nationally.
Averaging 254 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 15780% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 402% in 2019
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 | $157.80 | $56.68 | 2.78x | $101.12 | $23.7K | 418 | 6 |
| 2015 | $144.25 | $54.03 | 2.67x | $90.22 | $12.4K | 229 | 6 |
| 2017 | $83.67 | $32.75 | 2.55x | $50.92 | $37.5K | 1.1K | 10 |
| 2018 | $58.05 | $20.07 | 2.89x | $37.98 | $136.6K | 6.8K | 22 |
| 2019 | $72.26 | $19.23 | 3.76x | $53.03 | $685.4K | 35.6K | 26 |
| 2020 | $61.75 | $16.52 | 3.74x | $45.23 | $1.7M | 102.8K | 24 |
| 2021 | $64.91 | $15.99 | 4.06x | $48.92 | $1.7M | 107.1K | 22 |
| 2022 | $105.65 | $27.63 | 3.82x | $78.02 | $4.4M | 158.5K | 24 |
| 2023 | $90.92 | $23.63 | 3.85x | $67.29 | $3.8M | 159.2K | 24 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2507 | Injection, pegloticase, 1 mg | 1.8K | $4.5M | $2.5K | 3.73x |
| 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) | 103.2K | $3.9M | $38.23 | 3.90x |
| 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) | 356.4K | $1.8M | $5.00 | 4.13x |
| J1602 | Injection, golimumab, 1 mg, for intravenous use | 60.9K | $784.9K | $12.89 | 4.04x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 6.1K | $485.1K | $79.92 | 2.54x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 2.3K | $220.1K | $94.21 | 4.94x |
| J0897 | Injection, denosumab, 1 mg | 12.1K | $209.1K | $17.34 | 3.73x |
| 96401 | Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle | 1.9K | $99.1K | $52.40 | 5.00x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 600 | $86.3K | $143.75 | 2.45x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 551 | $60.9K | $110.54 | 2.47x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 420 | $46.7K | $111.28 | 2.42x |
| 96372 | Injection of drug or substance under skin or into muscle | 3.8K | $42.7K | $11.23 | 4.50x |
| 20611 | Aspiration and/or injection of fluid large joint using ultrasound guidance | 444 | $30.4K | $68.53 | 2.47x |
| 76881 | Complete ultrasound scan of joint | 347 | $19.8K | $56.98 | 3.62x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 336 | $15.6K | $46.32 | 2.59x |
| 96375 | Injection of additional new drug or substance into vein | 1.1K | $12.4K | $11.44 | 4.90x |
| 96415 | Administration of chemotherapy into vein, each additional hour | 546 | $11.3K | $20.74 | 4.90x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 241 | $11.0K | $45.49 | 5.44x |
| 94375 | Test to measure rate of airflow | 368 | $9.9K | $26.95 | 3.14x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 178 | $9.6K | $53.70 | 2.27x |
This provider submits charges 3.83 times higher than what Medicare actually pays.
A markup ratio of 3.83x means for every $100 Medicare pays, this provider initially charges $383. 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 AR for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Richard Houk, M.D. | Little Rock, AR | $52.6M | ✓ 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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