⚠️ This provider averages 594 services per working day — physically unusual for an individual practitioner
Based on 1.5M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $35.5M in total Medicare payments ranks in the 99th percentile of Rheumatology providers nationally.
Averaging 594 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 | $94.15 | $23.90 | 3.94x | $70.25 | $3.0M | 123.5K | 3.9K |
| 2015 | $58.06 | $23.90 | 2.43x | $34.16 | $3.7M | 152.9K | 4.8K |
| 2016 | $43.38 | $23.90 | 1.82x | $19.48 | $3.1M | 128.2K | 4.0K |
| 2017 | $75.53 | $23.90 | 3.16x | $51.63 | $4.0M | 166.4K | 5.2K |
| 2018 | $81.95 | $23.90 | 3.43x | $58.05 | $2.8M | 116.0K | 3.6K |
| 2019 | $50.73 | $23.90 | 2.12x | $26.83 | $3.7M | 154.3K | 4.8K |
| 2020 | $61.28 | $23.90 | 2.56x | $37.38 | $4.6M | 193.0K | 6.0K |
| 2021 | $39.38 | $23.90 | 1.65x | $15.48 | $2.9M | 121.3K | 3.8K |
| 2022 | $75.27 | $23.90 | 3.15x | $51.37 | $4.2M | 177.1K | 5.6K |
| 2023 | $61.58 | $23.90 | 2.58x | $37.68 | $3.7M | 153.0K | 4.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Office/outpatient visit, moderate complexity | 346.4K | $8.2M | $23.65 | 2.56x |
| 99213 | Office/outpatient visit, low complexity | 402.3K | $6.7M | $16.58 | 2.33x |
| 85025 | Complete blood cell count | 94.6K | $2.4M | $24.93 | 3.98x |
| 99215 | Office/outpatient visit, high complexity | 60.2K | $2.2M | $36.01 | 2.24x |
| 99203 | Office/outpatient visit, new patient | 73.6K | $2.1M | $27.97 | 2.57x |
| 80053 | Comprehensive metabolic panel | 99.4K | $1.7M | $17.07 | 4.34x |
| 36415 | Insertion of needle into vein for blood collection | 82.8K | $1.6M | $19.33 | 2.97x |
| 93000 | Electrocardiogram with interpretation | 62.4K | $1.5M | $24.31 | 2.79x |
| 71046 | Chest X-ray, 2 views | 33.2K | $1.1M | $33.02 | 2.81x |
| 96372 | Therapeutic injection | 51.4K | $1.1M | $20.45 | 2.74x |
This provider submits charges 2 times higher than what Medicare actually pays.
A markup ratio of 2x means for every $100 Medicare pays, this provider initially charges $200. This is lower 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.
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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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