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Methodology•Download Data
  1. Home
  2. Providers
  3. Nilesh Patel
⚕️
MDIndividual

Nilesh Patel, MD

NPI: 1508858903
Glendora, CA
10 years of data
Infectious Disease
$8.5M
Total Payments
34.9K
Beneficiaries
163.6K
Services
2.95x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$8.5M
Specialty median$93.3K

📋 Key Findings

1Billed $8.5M over 10 years
22.95x markup ratio (above median)
399th percentile in Infectious Disease by payments
465 services/day — unusually high
56 procedures with >3x markup

This provider averages 65 services per working day

Based on 163.6K total services over 10 years (250 working days/year). Learn about impossible service volumes →

🔎 Data Analysis

This provider's $8.5M in total Medicare payments ranks in the 99th percentile of Infectious Disease providers nationally.

Averaging 65 services per working day raises questions about billing patterns.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$163.94$57.492.85x$106.45$819.3K16.3K3.6K
2015$144.39$51.652.80x$92.74$794.7K17.2K3.8K
2016$144.98$52.302.77x$92.68$915.6K19.2K4.1K
2017$158.16$54.802.89x$103.36$901.4K19.9K3.8K
2018$153.58$56.592.71x$96.99$901.0K18.1K3.9K
2019$167.26$58.892.84x$108.37$973.9K18.8K4.1K
2020$167.60$56.722.95x$110.88$814.9K14.9K3.2K
2021$169.00$58.642.88x$110.36$732.1K13.1K2.7K
2022$183.31$67.142.73x$116.17$748.3K13.0K2.7K
2023$185.88$66.842.78x$119.04$896.3K13.2K3.0K

Top Procedures (20)

99232Subsequent hospital inpatient care, typically 25 minutes per day
$4.7M
76.7K services$60.95/svc2.76x markup
99233Subsequent hospital inpatient care, typically 35 minutes per day
$813.2K
8.9K services$91.30/svc2.97x markup
99214Established patient office or other outpatient, visit typically 25 minutes⚠ 3.3x markup
$589.0K
6.4K services$92.32/svc3.25x markup
99213Established patient office or other outpatient visit, typically 15 minutes⚠ 3.9x markup
$336.7K
5.2K services$64.16/svc3.90x markup
99223Initial hospital inpatient care, typically 70 minutes per day
$290.4K
1.7K services$166.64/svc3.00x markup
99222Initial hospital inpatient care, typically 50 minutes per day⚠ 3.5x markup
$288.8K
2.6K services$113.02/svc3.54x markup
99231Subsequent hospital inpatient care, typically 15 minutes per day⚠ 3.0x markup
$249.4K
7.6K services$32.99/svc3.03x markup
96372Injection beneath the skin or into muscle for therapy, diagnosis, or prevention⚠ 5.6x markup
$227.7K
12.7K services$17.89/svc5.59x markup
99291Critical care delivery critically ill or injured patient, first 30-74 minutes
$195.3K
1.1K services$183.91/svc2.72x markup
99308Subsequent nursing facility visit, typically 15 minutes per day
$152.6K
2.5K services$59.84/svc1.42x markup
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
$127.7K
998 services$128.00/svc1.17x markup
J3490Unclassified drugs
$57.5K
6.3K services$9.15/svc1.93x markup
G0181Physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of c
$52.7K
578 services$91.19/svc2.56x markup
99215Established patient office or other outpatient, visit typically 40 minutes
$44.0K
368 services$119.51/svc2.93x markup
99442Physician telephone patient service, 11-20 minutes of medical discussion
$43.0K
621 services$69.22/svc2.17x markup
90670Pneumococcal vaccine for injection into muscle
$35.2K
181 services$194.21/svc1.20x markup
G0008Administration of influenza virus vaccine⚠ 3.9x markup
$25.8K
1.0K services$25.67/svc3.90x markup
99204New patient office or other outpatient visit, typically 45 minutes
$25.5K
189 services$135.13/svc2.96x markup
99307Subsequent nursing facility visit, typically 10 minutes per day
$25.5K
683 services$37.39/svc2.14x markup
90662Vaccine for influenza for injection into muscle
$24.7K
450 services$54.92/svc1.82x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
99232Subsequent hospital inpatient care, typically 25 minutes per day76.7K$4.7M$60.952.76x
99233Subsequent hospital inpatient care, typically 35 minutes per day8.9K$813.2K$91.302.97x
99214Established patient office or other outpatient, visit typically 25 minutes6.4K$589.0K$92.323.25x
99213Established patient office or other outpatient visit, typically 15 minutes5.2K$336.7K$64.163.90x
99223Initial hospital inpatient care, typically 70 minutes per day1.7K$290.4K$166.643.00x
99222Initial hospital inpatient care, typically 50 minutes per day2.6K$288.8K$113.023.54x
99231Subsequent hospital inpatient care, typically 15 minutes per day7.6K$249.4K$32.993.03x
96372Injection beneath the skin or into muscle for therapy, diagnosis, or prevention12.7K$227.7K$17.895.59x
99291Critical care delivery critically ill or injured patient, first 30-74 minutes1.1K$195.3K$183.912.72x
99308Subsequent nursing facility visit, typically 15 minutes per day2.5K$152.6K$59.841.42x
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit998$127.7K$128.001.17x
J3490Unclassified drugs6.3K$57.5K$9.151.93x
G0181Physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of c578$52.7K$91.192.56x
99215Established patient office or other outpatient, visit typically 40 minutes368$44.0K$119.512.93x
99442Physician telephone patient service, 11-20 minutes of medical discussion621$43.0K$69.222.17x
90670Pneumococcal vaccine for injection into muscle181$35.2K$194.211.20x
G0008Administration of influenza virus vaccine1.0K$25.8K$25.673.90x
99204New patient office or other outpatient visit, typically 45 minutes189$25.5K$135.132.96x
99307Subsequent nursing facility visit, typically 10 minutes per day683$25.5K$37.392.14x
90662Vaccine for influenza for injection into muscle450$24.7K$54.921.82x

Markup Analysis

Charge-to-Payment Ratio

2.95x

This provider submits charges 2.95 times higher than what Medicare actually pays.

What This Means

A markup ratio of 2.95x means for every $100 Medicare pays, this provider initially charges $295. This is higher than the national average.

Location

Glendora, CA

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

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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