This provider averages 59 services per working day
Based on 148.6K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $5.7M in total Medicare payments ranks in the 97th percentile of Rheumatology providers nationally.
Averaging 59 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 | $92.12 | $40.42 | 2.28x | $51.70 | $578.2K | 16.4K | 5.8K |
| 2015 | $91.85 | $38.49 | 2.39x | $53.36 | $516.3K | 14.6K | 5.4K |
| 2016 | $97.46 | $40.65 | 2.40x | $56.81 | $521.7K | 15.5K | 5.6K |
| 2017 | $90.03 | $49.83 | 1.81x | $40.20 | $607.3K | 14.9K | 4.9K |
| 2018 | $89.67 | $38.21 | 2.35x | $51.46 | $563.5K | 17.3K | 5.8K |
| 2019 | $90.58 | $40.42 | 2.24x | $50.16 | $558.5K | 16.4K | 5.6K |
| 2020 | $76.62 | $34.07 | 2.25x | $42.55 | $526.9K | 13.1K | 4.5K |
| 2021 | $75.29 | $36.53 | 2.06x | $38.76 | $632.6K | 14.3K | 5.0K |
| 2022 | $73.78 | $35.11 | 2.10x | $38.67 | $607.8K | 13.4K | 4.9K |
| 2023 | $75.37 | $36.09 | 2.09x | $39.28 | $581.6K | 12.7K | 4.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 15.2K | $2.1M | $137.71 | 1.42x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 16.7K | $1.7M | $101.68 | 1.52x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 11.0K | $538.8K | $48.91 | 2.45x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 1.1K | $206.3K | $184.40 | 2.17x |
| 85027 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 21.6K | $162.8K | $7.53 | 3.99x |
| 85651 | Red blood cell sedimentation rate, to detect inflammation | 22.3K | $98.4K | $4.42 | 3.42x |
| 73564 | X-ray of knee, 4 or more views | 2.0K | $81.1K | $39.98 | 1.57x |
| 72052 | X-ray of upper spine, 6 or more views | 1.4K | $76.9K | $55.45 | 1.71x |
| 36415 | Insertion of needle into vein for collection of blood sample | 22.3K | $76.6K | $3.43 | 2.95x |
| 73130 | X-ray of hand, minimum of 3 views | 2.2K | $70.2K | $31.52 | 1.80x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 969 | $64.6K | $66.63 | 3.00x |
| 72110 | X-ray of lower and sacral spine, minimum of 4 views | 1.3K | $63.7K | $47.25 | 3.86x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 1.3K | $53.2K | $42.18 | 1.73x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 2.3K | $43.4K | $18.57 | 10.77x |
| 73630 | X-ray of foot, minimum of 3 views | 1.2K | $34.4K | $29.54 | 1.81x |
| 73030 | X-ray of shoulder, minimum of 2 views | 1.1K | $31.0K | $29.23 | 1.63x |
| 72114 | X-ray lower and sacral spine including bending views minimum 6 views | 477 | $26.9K | $56.42 | 3.23x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 288 | $26.2K | $90.81 | 1.66x |
| 72070 | X-ray of middle spine, 3 views | 823 | $25.4K | $30.81 | 1.98x |
| 73110 | X-ray of wrist, minimum of 3 views | 632 | $23.4K | $37.05 | 1.42x |
This provider submits charges 1.91 times higher than what Medicare actually pays.
A markup ratio of 1.91x means for every $100 Medicare pays, this provider initially charges $191. This is lower 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 CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Barry Eibschutz, M.D. | San Luis Obispo, CA | $55.8M | ✓ Clear |
| Shariar Cohen-Gadol, M.D. | Thousand Oaks, CA | $49.5M | ⚠️ Flagged |
| Gerald Ho, M.D. | La Palma, CA | $45.8M | ✓ Clear |
| Arash Horizon, M.D. | Los Angeles, CA | $45.0M | ✓ Clear |
| Daniel Watrous, M.D. | Visalia, CA | $41.6M | ✓ 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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