⚠️ This provider averages 404 services per working day — physically unusual for an individual practitioner
Based on 1.0M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $35.6M in total Medicare payments ranks in the 99th percentile of Neurology providers nationally.
Averaging 404 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 32390% from 2014 to 2023.
95% of their billing comes from a single procedure code (J1561 — Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 2565% 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 | $268.12 | $118.80 | 2.26x | $149.32 | $34.7K | 292 | 5 |
| 2015 | $276.86 | $120.52 | 2.30x | $156.34 | $34.6K | 287 | 5 |
| 2016 | $283.49 | $105.22 | 2.69x | $178.27 | $8.5K | 81 | 4 |
| 2017 | $295.77 | $106.06 | 2.79x | $189.71 | $65.1K | 614 | 6 |
| 2018 | $121.24 | $32.71 | 3.71x | $88.53 | $1.7M | 53.1K | 8 |
| 2019 | $117.34 | $31.24 | 3.76x | $86.10 | $3.4M | 108.7K | 11 |
| 2020 | $97.35 | $32.98 | 2.95x | $64.37 | $5.7M | 173.1K | 13 |
| 2021 | $82.10 | $36.60 | 2.24x | $45.50 | $6.9M | 189.9K | 10 |
| 2022 | $87.30 | $34.68 | 2.52x | $52.62 | $6.4M | 184.8K | 11 |
| 2023 | $85.09 | $37.70 | 2.26x | $47.39 | $11.3M | 299.0K | 11 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J1561 | Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg | 956.4K | $33.7M | $35.19 | 2.59x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 9.9K | $521.1K | $52.80 | 2.97x |
| 95886 | Needle measurement of electrical activity in arm or leg muscles, complete study | 4.6K | $346.4K | $75.35 | 3.19x |
| 95913 | Nerve conduction, 13 or more studies | 1.4K | $327.5K | $228.83 | 3.31x |
| 96366 | Infusion into a vein for therapy, prevention, or diagnosis, each additional hour | 19.8K | $326.8K | $16.50 | 3.79x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 1.8K | $223.0K | $123.00 | 2.91x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 401 | $62.4K | $155.54 | 2.87x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 418 | $36.0K | $86.11 | 2.79x |
| G2212 | Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or | 1.3K | $33.0K | $25.47 | 2.54x |
| 96375 | Injection of additional new drug or substance into vein | 1.4K | $17.4K | $12.07 | 2.97x |
| 95911 | Nerve transmission studies, 9-10 studies | 85 | $14.7K | $172.88 | 5.03x |
| 95912 | Nerve transmission studies, 11-12 studies | 67 | $13.0K | $193.64 | 3.77x |
| 11104 | Punch biopsy, first skin growth | 87 | $8.5K | $97.44 | 2.58x |
| 11105 | Punch biopsy, each additional skin growth | 173 | $8.0K | $46.39 | 2.53x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 99 | $6.1K | $61.45 | 3.04x |
| 99354 | Prolonged office or other outpatient service first hour | 39 | $3.9K | $99.47 | 3.59x |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 11.5K | $1.1K | $0.10 | 8.69x |
| 95811 | Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube | 11 | $1.1K | $99.37 | 5.28x |
| 95810 | Sleep monitoring of patient (6 years or older) in sleep lab | 11 | $1.1K | $95.53 | 5.28x |
| 36415 | Insertion of needle into vein for collection of blood sample | 199 | $944.40 | $4.75 | 1.26x |
This provider submits charges 2.63 times higher than what Medicare actually pays.
A markup ratio of 2.63x means for every $100 Medicare pays, this provider initially charges $263. 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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