⚠️ This provider averages 918 services per working day — physically unusual for an individual practitioner
Based on 2.3M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $19.4M in total Medicare payments ranks in the 99th percentile of Rheumatology providers nationally.
Averaging 918 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 2441% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1598% in 2018
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 |
|---|---|---|---|---|---|---|---|
| 2014 | $226.21 | $75.18 | 3.01x | $151.03 | $154.2K | 2.1K | 13 |
| 2015 | $247.70 | $75.99 | 3.26x | $171.71 | $60.3K | 793 | 7 |
| 2016 | $126.48 | $60.49 | 2.09x | $65.99 | $7.9K | 130 | 3 |
| 2017 | $68.73 | $22.98 | 2.99x | $45.75 | $101.2K | 4.4K | 44 |
| 2018 | $25.97 | $9.62 | 2.70x | $16.35 | $1.7M | 178.6K | 72 |
| 2019 | $26.97 | $9.69 | 2.78x | $17.28 | $2.4M | 252.5K | 67 |
| 2020 | $26.75 | $10.04 | 2.66x | $16.71 | $3.1M | 312.6K | 67 |
| 2021 | $24.97 | $8.97 | 2.78x | $16.00 | $4.1M | 453.0K | 63 |
| 2022 | $22.49 | $7.19 | 3.13x | $15.30 | $3.8M | 530.6K | 56 |
| 2023 | $23.32 | $7.00 | 3.33x | $16.32 | $3.9M | 559.8K | 56 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 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) | 1.5M | $7.9M | $5.22 | 3.06x |
| 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) | 109.4K | $4.1M | $37.42 | 2.94x |
| J3262 | Injection, tocilizumab, 1 mg | 284.4K | $1.3M | $4.52 | 2.31x |
| J0897 | Injection, denosumab, 1 mg | 74.3K | $1.2M | $16.38 | 1.77x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 7.5K | $612.8K | $82.26 | 2.49x |
| 86235 | Measurement of antibody for assessment of autoimmune disorder, any method | 17.8K | $321.4K | $18.10 | 2.43x |
| Q5121 | Injection, infliximab-axxq, biosimilar, (avsola), 10 mg | 8.5K | $294.2K | $34.53 | 2.98x |
| 96401 | Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle | 5.2K | $276.1K | $53.34 | 2.53x |
| 83970 | Parathormone (parathyroid hormone) level | 6.5K | $268.6K | $41.45 | 2.77x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 2.2K | $207.6K | $92.91 | 2.69x |
| 82306 | Vitamin d-3 level | 5.8K | $173.1K | $29.90 | 2.71x |
| J3111 | Injection, romosozumab-aqqg, 1 mg | 19.9K | $158.6K | $7.95 | 2.26x |
| 96372 | Injection of drug or substance under skin or into muscle | 13.4K | $139.8K | $10.46 | 5.26x |
| 86769 | Measure of severe acute respiratory syndrome coronavirus 2 (covid-19) antibody | 3.4K | $138.4K | $40.71 | 2.46x |
| Q5104 | Injection, infliximab-abda, biosimilar, (renflexis), 10 mg | 4.6K | $135.4K | $29.74 | 3.91x |
| J1602 | Injection, golimumab, 1 mg, for intravenous use | 12.8K | $128.6K | $10.09 | 5.06x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 7.4K | $112.2K | $15.10 | 3.97x |
| 82746 | Folic acid level, serum | 7.4K | $109.0K | $14.72 | 3.94x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 881 | $99.0K | $112.32 | 2.81x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.5K | $78.5K | $53.73 | 2.99x |
This provider submits charges 2.94 times higher than what Medicare actually pays.
A markup ratio of 2.94x means for every $100 Medicare pays, this provider initially charges $294. 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.
Share this provider's Medicare payment information
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