⚠️ This provider averages 997 services per working day — physically unusual for an individual practitioner
Based on 2.5M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $34.4M in total Medicare payments ranks in the 99th percentile of Rheumatology providers nationally.
Averaging 997 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 | $32.84 | $14.22 | 2.31x | $18.62 | $2.9M | 203.2K | 34 |
| 2015 | $39.63 | $17.62 | 2.25x | $22.01 | $3.1M | 178.0K | 33 |
| 2016 | $37.32 | $17.99 | 2.07x | $19.33 | $2.7M | 151.8K | 35 |
| 2017 | $23.79 | $11.90 | 2.00x | $11.89 | $2.9M | 241.5K | 37 |
| 2018 | $35.29 | $15.21 | 2.32x | $20.08 | $3.2M | 212.3K | 36 |
| 2019 | $39.53 | $15.50 | 2.55x | $24.03 | $3.7M | 240.9K | 33 |
| 2020 | $38.00 | $14.66 | 2.59x | $23.34 | $3.9M | 264.2K | 38 |
| 2021 | $42.75 | $15.23 | 2.81x | $27.52 | $4.2M | 275.3K | 29 |
| 2022 | $33.41 | $11.79 | 2.83x | $21.62 | $3.8M | 324.5K | 30 |
| 2023 | $19.21 | $9.70 | 1.98x | $9.51 | $3.9M | 399.6K | 30 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J1602 | Injection, golimumab, 1 mg, for intravenous use | 550.4K | $8.0M | $14.61 | 3.09x |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 129.2K | $6.6M | $51.27 | 2.51x |
| 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) | 163.7K | $6.2M | $38.18 | 1.77x |
| J3262 | Injection, tocilizumab, 1 mg | 1.0M | $4.0M | $3.88 | 1.96x |
| J9310 | Injection, rituximab, 100 mg | 4.6K | $2.8M | $596.29 | 2.05x |
| 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) | 470.4K | $2.5M | $5.36 | 1.65x |
| J9312 | Injection, rituximab, 10 mg | 16.5K | $1.2M | $73.38 | 2.01x |
| J0897 | Injection, denosumab, 1 mg | 41.9K | $609.5K | $14.55 | 2.10x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 4.0K | $434.4K | $108.96 | 2.68x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 4.0K | $390.3K | $97.02 | 3.18x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 7.3K | $363.6K | $50.09 | 4.19x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 4.1K | $316.8K | $76.75 | 2.74x |
| 96415 | Administration of chemotherapy into vein, each additional hour | 7.8K | $162.5K | $20.90 | 5.12x |
| 86235 | Measurement of antibody for assessment of autoimmune disorder, any method | 4.5K | $95.4K | $21.32 | 2.91x |
| 96372 | Injection of drug or substance under skin or into muscle | 4.7K | $63.4K | $13.61 | 3.71x |
| 76881 | Complete ultrasound of arm or leg | 803 | $60.5K | $75.32 | 4.05x |
| 80053 | Blood test, comprehensive group of blood chemicals | 4.0K | $45.8K | $11.53 | 4.94x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 3.9K | $34.7K | $8.89 | 4.94x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 540 | $28.5K | $52.85 | 3.31x |
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 385 | $25.0K | $65.00 | 4.09x |
This provider submits charges 2.4 times higher than what Medicare actually pays.
A markup ratio of 2.4x means for every $100 Medicare pays, this provider initially charges $240. 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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