⚠️ 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 →
This provider's $33.9M 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.
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 | $39.13 | $9.94 | 3.94x | $29.19 | $2.3M | 231.5K | 31 |
| 2015 | $42.32 | $11.21 | 3.78x | $31.11 | $2.8M | 250.9K | 37 |
| 2016 | $45.38 | $12.08 | 3.76x | $33.30 | $2.8M | 229.0K | 33 |
| 2017 | $43.39 | $12.38 | 3.50x | $31.01 | $3.4M | 274.3K | 31 |
| 2018 | $45.87 | $12.85 | 3.57x | $33.02 | $3.5M | 273.9K | 29 |
| 2019 | $48.72 | $13.30 | 3.66x | $35.42 | $3.8M | 286.6K | 29 |
| 2020 | $46.11 | $13.15 | 3.51x | $32.96 | $3.9M | 299.5K | 32 |
| 2021 | $43.04 | $12.23 | 3.52x | $30.81 | $4.1M | 336.7K | 29 |
| 2022 | $38.26 | $10.72 | 3.57x | $27.54 | $4.1M | 386.5K | 30 |
| 2023 | $32.47 | $10.28 | 3.16x | $22.19 | $3.1M | 300.7K | 27 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0897 | Injection, denosumab, 1 mg | 767.8K | $11.2M | $14.55 | 3.78x |
| 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) | 118.1K | $4.3M | $36.12 | 3.40x |
| 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) | 763.2K | $4.2M | $5.45 | 4.59x |
| J3262 | Injection, tocilizumab, 1 mg | 819.2K | $3.1M | $3.73 | 2.68x |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 54.8K | $2.9M | $52.07 | 3.17x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 20.8K | $2.0M | $97.83 | 3.07x |
| J3111 | Injection, romosozumab-aqqg, 1 mg | 186.5K | $1.4M | $7.61 | 1.88x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 4.5K | $590.9K | $132.43 | 3.02x |
| J1602 | Injection, golimumab, 1 mg, for intravenous use | 30.3K | $459.9K | $15.20 | 4.93x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 7.0K | $428.3K | $61.20 | 3.27x |
| J9310 | Injection, rituximab, 100 mg | 582 | $396.3K | $681.00 | 2.69x |
| J9312 | Injection, rituximab, 10 mg | 5.3K | $390.8K | $74.44 | 2.69x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.6K | $372.2K | $145.45 | 2.75x |
| 77080 | Dxa bone density measurement of hip, pelvis, spine | 7.0K | $342.2K | $48.88 | 7.16x |
| 96401 | Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle | 4.8K | $333.9K | $69.80 | 2.87x |
| 20611 | Aspiration and/or injection of fluid large joint using ultrasound guidance | 3.4K | $302.5K | $87.74 | 5.13x |
| J3304 | Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg | 15.3K | $215.3K | $14.08 | 4.44x |
| 96372 | Injection of drug or substance under skin or into muscle | 13.6K | $213.5K | $15.64 | 3.84x |
| 77085 | Dxa bone density measurement of hip, pelvis, spine including spine fracture assessment | 2.0K | $125.8K | $64.10 | 5.41x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 968 | $107.7K | $111.28 | 2.94x |
This provider submits charges 3.58 times higher than what Medicare actually pays.
A markup ratio of 3.58x means for every $100 Medicare pays, this provider initially charges $358. 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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