⚠️ This provider averages 483 services per working day — physically unusual for an individual practitioner
Based on 1.1M total services over 9 years (250 working days/year). Learn about impossible service volumes →
This provider's $17.3M in total Medicare payments ranks in the 99th percentile of Rheumatology providers nationally.
Averaging 483 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 21415% from 2015 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 7448% in 2016
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 | $175.44 | $75.07 | 2.34x | $100.37 | $13.6K | 181 | 6 |
| 2016 | $41.70 | $19.51 | 2.14x | $22.19 | $1.0M | 52.5K | 20 |
| 2017 | $36.97 | $18.66 | 1.98x | $18.31 | $1.7M | 91.9K | 19 |
| 2018 | $35.94 | $17.93 | 2.00x | $18.01 | $2.5M | 138.1K | 21 |
| 2019 | $41.88 | $18.05 | 2.32x | $23.83 | $2.2M | 122.2K | 21 |
| 2020 | $42.10 | $17.53 | 2.40x | $24.57 | $1.9M | 106.1K | 20 |
| 2021 | $41.56 | $15.59 | 2.67x | $25.97 | $2.5M | 158.4K | 20 |
| 2022 | $41.30 | $13.72 | 3.01x | $27.58 | $2.6M | 191.4K | 21 |
| 2023 | $44.16 | $12.96 | 3.41x | $31.20 | $2.9M | 225.6K | 23 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 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) | 127.4K | $4.8M | $37.60 | 2.28x |
| J3262 | Injection, tocilizumab, 1 mg | 643.7K | $2.7M | $4.17 | 2.50x |
| J9312 | Injection, rituximab, 10 mg | 36.1K | $2.4M | $66.68 | 2.91x |
| J1602 | Injection, golimumab, 1 mg, for intravenous use | 150.8K | $2.1M | $14.23 | 2.88x |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 38.1K | $1.9M | $50.09 | 2.66x |
| J9310 | Injection, rituximab, 100 mg | 1.8K | $1.1M | $653.48 | 1.99x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 6.2K | $513.8K | $83.49 | 2.88x |
| J0897 | Injection, denosumab, 1 mg | 24.6K | $380.7K | $15.48 | 2.41x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 3.7K | $379.5K | $101.63 | 2.72x |
| J0490 | Injection, belimumab, 10 mg | 10.4K | $368.3K | $35.48 | 3.24x |
| 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) | 17.8K | $111.2K | $6.25 | 2.01x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 915 | $109.1K | $119.28 | 2.72x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 2.0K | $100.9K | $49.97 | 3.14x |
| J3111 | Injection, romosozumab-aqqg, 1 mg | 7.6K | $54.4K | $7.19 | 4.73x |
| 96415 | Administration of chemotherapy into vein, each additional hour | 2.2K | $48.8K | $22.28 | 2.67x |
| 96401 | Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle | 746 | $43.7K | $58.54 | 2.46x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 208 | $26.7K | $128.49 | 2.84x |
| 96375 | Injection of additional new drug or substance into vein | 1.4K | $18.4K | $13.23 | 2.74x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 224 | $12.7K | $56.91 | 2.82x |
| 36415 | Insertion of needle into vein for collection of blood sample | 3.0K | $12.2K | $4.04 | 3.16x |
This provider submits charges 2.58 times higher than what Medicare actually pays.
A markup ratio of 2.58x means for every $100 Medicare pays, this provider initially charges $258. This is higher 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 FL for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Aymen Kenawy, M.D. | Lynn Haven, FL | $56.3M | ✓ Clear |
| Vipul Joshi, MD | Brandon, FL | $41.8M | ✓ Clear |
| Adam Rosen, MD | Clearwater, FL | $38.6M | ✓ Clear |
| Eugenia Rullan Bidot, MD | Clearwater, FL | $38.2M | ✓ Clear |
| Marc Hirsh, M.D. | Delray Beach, FL | $33.8M | ✓ 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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