This provider averages 91 services per working day
Based on 226.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $7.1M in total Medicare payments ranks in the 98th percentile of Rheumatology providers nationally.
Averaging 91 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 | $82.64 | $48.04 | 1.72x | $34.60 | $923.1K | 30.5K | 15.7K |
| 2015 | $63.95 | $32.35 | 1.98x | $31.60 | $761.7K | 26.4K | 13.5K |
| 2016 | $63.47 | $31.30 | 2.03x | $32.17 | $762.0K | 26.2K | 13.1K |
| 2017 | $79.99 | $42.30 | 1.89x | $37.69 | $895.1K | 29.7K | 15.2K |
| 2018 | $80.61 | $43.72 | 1.84x | $36.89 | $733.5K | 24.8K | 13.7K |
| 2019 | $63.65 | $30.58 | 2.08x | $33.07 | $716.5K | 23.4K | 12.0K |
| 2020 | $68.62 | $33.37 | 2.06x | $35.25 | $656.3K | 20.5K | 11.1K |
| 2021 | $69.17 | $35.14 | 1.97x | $34.03 | $639.2K | 17.2K | 8.5K |
| 2022 | $64.86 | $32.56 | 1.99x | $32.30 | $528.8K | 15.1K | 7.6K |
| 2023 | $63.37 | $30.38 | 2.09x | $32.99 | $454.8K | 13.1K | 6.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 29.9K | $2.3M | $75.36 | 1.87x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 9.9K | $972.7K | $98.10 | 2.35x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 8.8K | $479.4K | $54.48 | 2.11x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 3.7K | $422.8K | $114.91 | 1.54x |
| J7321 | Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose | 4.6K | $300.3K | $65.78 | 1.55x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 4.8K | $263.5K | $55.33 | 1.61x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.2K | $243.1K | $112.08 | 2.15x |
| 20553 | Injections of trigger points in 3 or more muscles | 5.0K | $224.2K | $44.71 | 1.98x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 14.4K | $134.5K | $9.35 | 2.67x |
| 96375 | Injection of different drug or substance into a vein for therapy, diagnosis, or prevention | 9.3K | $129.5K | $13.95 | 3.50x |
| 96415 | Infusion of chemotherapy into a vein | 5.7K | $123.5K | $21.50 | 2.56x |
| J9310 | Injection, rituximab, 100 mg | 167 | $108.3K | $648.40 | 1.36x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 7.5K | $107.4K | $14.40 | 2.08x |
| 20552 | Injections of trigger points in 1 or 2 muscles | 2.8K | $102.8K | $36.09 | 2.13x |
| 86140 | Measurement C-reactive protein for detection of infection or inflammation | 14.9K | $92.6K | $6.21 | 2.42x |
| 77080 | Bone density measurement using dedicated X-ray machine | 2.3K | $86.5K | $38.26 | 3.11x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.5K | $84.1K | $56.51 | 2.08x |
| 85651 | Red blood cell sedimentation rate, to detect inflammation | 15.3K | $68.6K | $4.48 | 2.23x |
| 86235 | Measurement of antibody for assessment of autoimmune disorder | 2.6K | $58.0K | $22.28 | 1.57x |
| J1745 | Injection infliximab, 10 mg | 1.2K | $56.1K | $47.65 | 2.29x |
This provider submits charges 2.03 times higher than what Medicare actually pays.
A markup ratio of 2.03x means for every $100 Medicare pays, this provider initially charges $203. 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.
Other Rheumatology providers in TX for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Constantine Saadeh, M.D. | Amarillo, TX | $39.3M | ✓ Clear |
| Grace Makhlouf, M.D. | Sugar Land, TX | $34.2M | ✓ Clear |
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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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