This provider averages 58 services per working day
Based on 146.2K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $5.1M in total Medicare payments ranks in the 97th percentile of Rheumatology providers nationally.
Averaging 58 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 | $117.31 | $32.92 | 3.56x | $84.39 | $392.9K | 14.7K | 8.4K |
| 2015 | $104.65 | $27.45 | 3.81x | $77.20 | $435.8K | 16.3K | 8.5K |
| 2016 | $142.20 | $49.65 | 2.86x | $92.55 | $530.7K | 16.2K | 7.8K |
| 2017 | $135.60 | $46.34 | 2.93x | $89.26 | $612.2K | 19.1K | 10.9K |
| 2018 | $115.25 | $40.37 | 2.85x | $74.88 | $621.8K | 24.5K | 12.9K |
| 2019 | $87.73 | $30.22 | 2.90x | $57.51 | $616.0K | 23.5K | 11.5K |
| 2020 | $90.83 | $42.30 | 2.15x | $48.53 | $497.7K | 8.9K | 4.6K |
| 2021 | $104.53 | $47.21 | 2.21x | $57.32 | $524.6K | 8.4K | 4.4K |
| 2022 | $111.02 | $45.94 | 2.42x | $65.08 | $434.7K | 7.3K | 4.1K |
| 2023 | $121.69 | $49.55 | 2.46x | $72.14 | $450.1K | 7.4K | 3.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 20.1K | $1.6M | $77.60 | 2.35x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 8.2K | $917.6K | $111.34 | 2.39x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 9.6K | $568.2K | $59.06 | 3.78x |
| 76881 | Ultrasound of leg or arm | 8.7K | $565.9K | $64.77 | 2.92x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 1.3K | $195.6K | $151.14 | 2.34x |
| 80053 | Blood test, comprehensive group of blood chemicals | 11.7K | $149.9K | $12.85 | 3.99x |
| J7327 | Hyaluronan or derivative, monovisc, for intra-articular injection, per dose | 177 | $123.7K | $698.82 | 1.72x |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 9.5K | $75.0K | $7.92 | 2.60x |
| 82306 | Vitamin D-3 level | 1.9K | $73.4K | $37.97 | 5.98x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 7.8K | $72.2K | $9.26 | 2.58x |
| 77080 | Bone density measurement using dedicated X-ray machine | 1.8K | $70.2K | $39.58 | 4.93x |
| 73562 | X-ray of knee, 3 views | 2.1K | $62.6K | $29.31 | 3.28x |
| 85651 | Red blood cell sedimentation rate, to detect inflammation | 10.6K | $47.8K | $4.51 | 4.81x |
| 20552 | Injections of trigger points in 1 or 2 muscles | 1.4K | $47.3K | $32.67 | 3.96x |
| 81002 | Urinalysis, manual test | 12.3K | $41.7K | $3.40 | 4.50x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 1.4K | $41.2K | $28.86 | 3.39x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 2.5K | $40.5K | $15.98 | 2.96x |
| 80307 | Testing for presence of drug | 505 | $35.0K | $69.33 | 1.77x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 1.5K | $33.5K | $21.81 | 4.49x |
| G0307 | Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) | 3.8K | $32.6K | $8.63 | 3.25x |
This provider submits charges 2.92 times higher than what Medicare actually pays.
A markup ratio of 2.92x means for every $100 Medicare pays, this provider initially charges $292. 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 VA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Elena Flagg, M.D. | Williamsburg, VA | $42.6M | ✓ Clear |
| Michael Strachan, M.D. | Richmond, VA | $36.6M | ✓ 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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