⚠️ This provider averages 913 services per working day — physically unusual for an individual practitioner
Based on 2.3M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $39.3M in total Medicare payments ranks in the 99th percentile of Rheumatology providers nationally.
Averaging 913 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 | $41.64 | $12.68 | 3.28x | $28.96 | $4.1M | 322.7K | 83 |
| 2015 | $33.91 | $12.35 | 2.75x | $21.56 | $4.6M | 371.8K | 88 |
| 2016 | $43.98 | $14.56 | 3.02x | $29.42 | $4.6M | 316.9K | 98 |
| 2017 | $47.79 | $16.45 | 2.91x | $31.34 | $4.2M | 254.2K | 83 |
| 2018 | $48.98 | $19.02 | 2.58x | $29.96 | $4.2M | 222.8K | 79 |
| 2019 | $55.44 | $21.53 | 2.58x | $33.91 | $4.2M | 195.6K | 73 |
| 2020 | $60.89 | $23.35 | 2.61x | $37.54 | $3.1M | 133.2K | 63 |
| 2021 | $74.45 | $27.17 | 2.74x | $47.28 | $3.6M | 134.3K | 76 |
| 2022 | $64.49 | $19.24 | 3.35x | $45.25 | $3.1M | 158.6K | 73 |
| 2023 | $94.51 | $20.60 | 4.59x | $73.91 | $3.6M | 173.7K | 79 |
| 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) | 212.6K | $7.1M | $33.22 | 2.95x |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 100.1K | $5.3M | $52.80 | 3.03x |
| J2357 | Injection, omalizumab, 5 mg | 198.7K | $5.2M | $26.26 | 3.05x |
| J3262 | Injection, tocilizumab, 1 mg | 810.8K | $2.7M | $3.27 | 2.87x |
| J9312 | Injection, rituximab, 10 mg | 34.1K | $2.4M | $69.63 | 2.93x |
| J9310 | Injection, rituximab, 100 mg | 3.1K | $1.9M | $609.44 | 2.17x |
| J1602 | Injection, golimumab, 1 mg, for intravenous use | 117.9K | $1.9M | $16.18 | 3.32x |
| J1569 | Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg | 43.8K | $1.5M | $34.02 | 2.91x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 15.3K | $1.3M | $81.96 | 2.69x |
| J0897 | Injection, denosumab, 1 mg | 80.8K | $1.2M | $14.39 | 2.86x |
| 95165 | Professional service for preparation and provision of 1 or more antigens | 114.5K | $1.1M | $9.90 | 3.19x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 8.9K | $872.0K | $98.36 | 3.48x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 9.9K | $514.7K | $51.74 | 2.85x |
| 96401 | Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle | 9.0K | $498.9K | $55.54 | 3.12x |
| J0490 | Injection, belimumab, 10 mg | 12.6K | $433.9K | $34.48 | 2.52x |
| 95004 | Test for allergy using allergenic extract | 104.5K | $400.3K | $3.83 | 4.97x |
| 95117 | Professional service for multiple injections of allergen | 47.2K | $338.1K | $7.17 | 4.62x |
| J1568 | Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg | 10.9K | $303.3K | $27.78 | 2.55x |
| 80053 | Blood test, comprehensive group of blood chemicals | 20.0K | $244.9K | $12.27 | 2.47x |
| 20611 | Aspiration and/or injection of fluid large joint using ultrasound guidance | 3.8K | $243.9K | $63.40 | 3.80x |
This provider submits charges 3.02 times higher than what Medicare actually pays.
A markup ratio of 3.02x means for every $100 Medicare pays, this provider initially charges $302. 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 |
|---|---|---|---|
| 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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