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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Providers
  3. Edward Allegra
⚕️
MDIndividual

Edward Allegra, MD

NPI: 1588665913
Red Bank, NJ
10 years of data
Rheumatology
$25.9M
Total Payments
240
Beneficiaries
2.9M
Services
1.91x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$25.9M
Specialty median$352.6K

📋 Key Findings

1Billed $25.9M over 10 years
21.91x markup ratio
399th percentile in Rheumatology by payments
41.1K services/day — physically implausible
52 procedures with >3x markup

⚠️ This provider averages 1.1K services per working day — physically unusual for an individual practitioner

Based on 2.9M total services over 10 years (250 working days/year). Learn about impossible service volumes →

🔎 Data Analysis

This provider's $25.9M in total Medicare payments ranks in the 99th percentile of Rheumatology providers nationally.

Averaging 1.1K services per working day raises questions about billing patterns.

Medicare payments to this provider grew 198% from 2014 to 2023.

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$15.37$8.621.78x$6.75$1.2M138.6K23
2015$14.79$8.731.69x$6.06$1.3M147.2K24
2016$13.29$8.531.56x$4.76$1.8M208.7K20
2017$14.92$9.291.61x$5.63$2.1M227.5K23
2018$17.09$10.451.64x$6.64$2.2M213.3K23
2019$16.59$9.511.74x$7.08$3.1M329.1K24
2020$16.80$9.671.74x$7.13$3.5M366.2K25
2021$18.03$9.261.95x$8.77$3.6M389.0K25
2022$19.69$8.692.27x$11.00$3.4M395.6K25
2023$20.38$8.082.52x$12.30$3.6M441.5K28

Top Procedures (20)

J0717Injection, 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)
$10.0M
1.9M services$5.38/svc1.95x markup
J0129Injection, 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)
$5.7M
156.8K services$36.50/svc1.71x markup
J1602Injection, golimumab, 1 mg, for intravenous use
$2.0M
161.1K services$12.37/svc2.43x markup
J3262Injection, tocilizumab, 1 mg
$1.9M
435.0K services$4.30/svc1.70x markup
J0897Injection, denosumab, 1 mg
$1.2M
80.5K services$14.99/svc1.53x markup
99213Established patient office or other outpatient visit, 20-29 minutes
$1.1M
18.1K services$58.21/svc1.75x markup
96413Administration of chemotherapy into vein, 1 hour or less
$620.3K
5.0K services$123.83/svc1.59x markup
96401Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle
$476.0K
7.0K services$67.94/svc2.17x markup
99212Established patient office or other outpatient visit, 10-19 minutes
$418.2K
11.8K services$35.35/svc1.84x markup
J3111Injection, romosozumab-aqqg, 1 mg
$321.5K
40.7K services$7.89/svc1.58x markup
20611Aspiration and/or injection of fluid large joint using ultrasound guidance
$291.6K
3.6K services$81.41/svc2.50x markup
99214Established patient office or other outpatient visit, 30-39 minutes
$286.8K
3.3K services$86.34/svc1.55x markup
Q5104Injection, infliximab-abda, biosimilar, (renflexis), 10 mg
$250.3K
7.3K services$34.39/svc2.91x markup
20610Aspiration and/or injection of fluid from large joint
$192.3K
3.6K services$53.17/svc1.94x markup
J1745Injection, infliximab, excludes biosimilar, 10 mg⚠ 3.3x markup
$189.8K
6.2K services$30.56/svc3.27x markup
J0702Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg
$116.9K
23.4K services$4.99/svc1.77x markup
J7324Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose
$103.1K
724 services$142.43/svc2.59x markup
J7329Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg
$91.7K
8.8K services$10.42/svc2.40x markup
20552Injections of trigger points in 1 or 2 muscles
$84.1K
1.9K services$43.28/svc1.54x markup
96372Injection of drug or substance under skin or into muscle⚠ 3.2x markup
$74.8K
5.6K services$13.43/svc3.19x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
J0717Injection, 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)1.9M$10.0M$5.381.95x
J0129Injection, 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)156.8K$5.7M$36.501.71x
J1602Injection, golimumab, 1 mg, for intravenous use161.1K$2.0M$12.372.43x
J3262Injection, tocilizumab, 1 mg435.0K$1.9M$4.301.70x
J0897Injection, denosumab, 1 mg80.5K$1.2M$14.991.53x
99213Established patient office or other outpatient visit, 20-29 minutes18.1K$1.1M$58.211.75x
96413Administration of chemotherapy into vein, 1 hour or less5.0K$620.3K$123.831.59x
96401Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle7.0K$476.0K$67.942.17x
99212Established patient office or other outpatient visit, 10-19 minutes11.8K$418.2K$35.351.84x
J3111Injection, romosozumab-aqqg, 1 mg40.7K$321.5K$7.891.58x
20611Aspiration and/or injection of fluid large joint using ultrasound guidance3.6K$291.6K$81.412.50x
99214Established patient office or other outpatient visit, 30-39 minutes3.3K$286.8K$86.341.55x
Q5104Injection, infliximab-abda, biosimilar, (renflexis), 10 mg7.3K$250.3K$34.392.91x
20610Aspiration and/or injection of fluid from large joint3.6K$192.3K$53.171.94x
J1745Injection, infliximab, excludes biosimilar, 10 mg6.2K$189.8K$30.563.27x
J0702Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg23.4K$116.9K$4.991.77x
J7324Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose724$103.1K$142.432.59x
J7329Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg8.8K$91.7K$10.422.40x
20552Injections of trigger points in 1 or 2 muscles1.9K$84.1K$43.281.54x
96372Injection of drug or substance under skin or into muscle5.6K$74.8K$13.433.19x

Markup Analysis

Charge-to-Payment Ratio

1.91x

This provider submits charges 1.91 times higher than what Medicare actually pays.

What This Means

A markup ratio of 1.91x means for every $100 Medicare pays, this provider initially charges $191. This is lower than the national average.

Location

Red Bank, NJ

Provider Verification

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

Similar Providers

Other Rheumatology providers in NJ for peer comparison.

Edward Allegra (you)
$25.9M
Stephen Soloway, M.D.,FACP.,FACR.,CCD
$42.7M
Steven Golombek, M.D.
$34.7M
Show detailed table ▾
ProviderLocationTotal PaymentsStatus
Stephen Soloway, M.D.,FACP.,FACR.,CCDVineland, NJ$42.7M✓ Clear
Steven Golombek, M.D.Dover, NJ$34.7M✓ Clear

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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.

Believe this data is inaccurate? Dispute this data