⚠️ This provider averages 296 services per working day — physically unusual for an individual practitioner
Based on 518.8K total services over 7 years (250 working days/year). Learn about impossible service volumes →
This provider's $14.8M in total Medicare payments ranks in the 99th percentile of Emergency Medicine providers nationally.
Averaging 296 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 36001% from 2015 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 4703% in 2020
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 |
|---|---|---|---|---|---|---|---|
| 2015 | $176.50 | $54.01 | 3.27x | $122.49 | $19.3K | 357 | 8 |
| 2016 | $1.7K | $138.67 | 12.39x | $1.6K | $4.0K | 29 | 1 |
| 2019 | $64.01 | $24.54 | 2.61x | $39.47 | $47.4K | 1.9K | 6 |
| 2020 | $140.48 | $61.36 | 2.29x | $79.12 | $2.3M | 37.1K | 17 |
| 2021 | $35.12 | $9.53 | 3.69x | $25.59 | $1.0M | 106.5K | 25 |
| 2022 | $84.75 | $30.04 | 2.82x | $54.71 | $4.4M | 147.4K | 32 |
| 2023 | $87.66 | $30.87 | 2.84x | $56.79 | $7.0M | 225.4K | 33 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J3241 | Injection, teprotumumab-trbw, 10 mg | 23.1K | $5.8M | $253.69 | 1.82x |
| J3590 | Unclassified biologics | 15.2K | $1.9M | $125.71 | 2.07x |
| J0897 | Injection, denosumab, 1 mg | 58.4K | $1.0M | $17.65 | 3.28x |
| J3380 | Injection, vedolizumab, 1 mg | 57.9K | $984.4K | $17.00 | 3.49x |
| J3111 | Injection, romosozumab-aqqg, 1 mg | 127.3K | $964.3K | $7.58 | 3.52x |
| J3245 | Injection, tildrakizumab, 1 mg | 6.5K | $672.8K | $103.50 | 4.24x |
| 99487 | Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month | 4.7K | $458.7K | $97.19 | 2.85x |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 11.4K | $315.7K | $27.65 | 6.04x |
| J3490 | Unclassified drugs | 10.7K | $307.0K | $28.63 | 3.65x |
| J2356 | Injection, tezepelumab-ekko, 1 mg | 21.2K | $298.1K | $14.05 | 5.69x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 5.0K | $275.0K | $54.74 | 3.86x |
| 99489 | Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month | 4.7K | $239.8K | $50.51 | 2.66x |
| J1306 | Injection, inclisiran, 1 mg | 23.9K | $222.3K | $9.32 | 6.78x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 2.9K | $205.1K | $70.99 | 3.12x |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 3.5K | $158.7K | $44.73 | 3.13x |
| 96360 | Infusion into a vein for hydration, 31-60 minutes | 5.6K | $154.7K | $27.57 | 3.76x |
| J0875 | Injection, dalbavancin, 5 mg | 11.1K | $136.6K | $12.31 | 3.60x |
| 96366 | Infusion into a vein for therapy, prevention, or diagnosis, each additional hour | 5.2K | $88.9K | $17.03 | 3.74x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 903 | $87.0K | $96.35 | 3.21x |
| J1439 | Injection, ferric carboxymaltose, 1 mg | 96.0K | $84.2K | $0.88 | 5.61x |
This provider submits charges 2.81 times higher than what Medicare actually pays.
A markup ratio of 2.81x means for every $100 Medicare pays, this provider initially charges $281. 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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