⚠️ This provider averages 697 services per working day — physically unusual for an individual practitioner
Based on 1.7M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $23.7M in total Medicare payments ranks in the 99th percentile of Rheumatology providers nationally.
Averaging 697 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 174% from 2014 to 2023.
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 | $42.08 | $15.84 | 2.66x | $26.24 | $1.1M | 69.8K | 33 |
| 2015 | $35.78 | $12.73 | 2.81x | $23.05 | $1.2M | 97.5K | 30 |
| 2016 | $32.97 | $13.07 | 2.52x | $19.90 | $1.7M | 128.4K | 31 |
| 2017 | $34.08 | $13.59 | 2.51x | $20.49 | $1.7M | 126.4K | 29 |
| 2018 | $37.00 | $14.95 | 2.47x | $22.05 | $2.2M | 149.9K | 30 |
| 2019 | $46.29 | $17.56 | 2.64x | $28.73 | $2.7M | 153.3K | 32 |
| 2020 | $37.95 | $14.26 | 2.66x | $23.69 | $3.2M | 223.1K | 31 |
| 2021 | $38.12 | $13.58 | 2.81x | $24.54 | $3.4M | 250.7K | 33 |
| 2022 | $38.64 | $11.83 | 3.27x | $26.81 | $3.4M | 290.4K | 35 |
| 2023 | $40.14 | $11.95 | 3.36x | $28.19 | $3.0M | 253.6K | 28 |
| 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) | 179.0K | $6.5M | $36.25 | 2.11x |
| J0897 | Injection, denosumab, 1 mg | 221.8K | $3.3M | $14.66 | 2.38x |
| J1602 | Injection, golimumab, 1 mg, for intravenous use | 161.4K | $2.3M | $14.54 | 3.10x |
| J3262 | Injection, tocilizumab, 1 mg | 598.8K | $2.3M | $3.87 | 2.07x |
| J9312 | Injection, rituximab, 10 mg | 31.3K | $2.1M | $66.81 | 3.58x |
| 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) | 369.8K | $1.9M | $5.24 | 3.43x |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 35.9K | $1.8M | $51.24 | 3.05x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 9.3K | $658.4K | $71.06 | 2.23x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 10.6K | $516.8K | $48.86 | 2.14x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 5.3K | $476.7K | $89.14 | 4.13x |
| J9310 | Injection, rituximab, 100 mg | 660 | $380.0K | $575.70 | 2.32x |
| 20611 | Aspiration and/or injection of fluid large joint using ultrasound guidance | 2.5K | $180.6K | $72.72 | 14.23x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.5K | $170.3K | $110.60 | 2.04x |
| 20610 | Aspiration and/or injection of fluid from large joint | 3.7K | $162.6K | $44.44 | 6.55x |
| J3111 | Injection, romosozumab-aqqg, 1 mg | 19.1K | $147.9K | $7.74 | 3.49x |
| 96401 | Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle | 3.0K | $145.3K | $48.97 | 3.68x |
| J1740 | Injection, ibandronate sodium, 1 mg | 1.2K | $78.3K | $65.39 | 3.67x |
| J7325 | Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg | 8.0K | $75.0K | $9.42 | 3.43x |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 698 | $49.8K | $71.31 | 2.13x |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 33.7K | $39.7K | $1.18 | 4.25x |
This provider submits charges 2.83 times higher than what Medicare actually pays.
A markup ratio of 2.83x means for every $100 Medicare pays, this provider initially charges $283. 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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