⚠️ This provider averages 1.1K services per working day — physically unusual for an individual practitioner
Based on 2.7M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $40.7M 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 | $38.09 | $16.58 | 2.30x | $21.51 | $4.4M | 262.7K | 85 |
| 2015 | $35.74 | $15.75 | 2.27x | $19.99 | $4.2M | 265.6K | 84 |
| 2016 | $44.72 | $17.92 | 2.50x | $26.80 | $3.7M | 204.2K | 84 |
| 2017 | $47.80 | $19.33 | 2.47x | $28.47 | $4.2M | 218.1K | 85 |
| 2018 | $40.83 | $16.52 | 2.47x | $24.31 | $4.5M | 271.9K | 77 |
| 2019 | $40.78 | $15.27 | 2.67x | $25.51 | $4.0M | 259.2K | 79 |
| 2020 | $39.30 | $13.77 | 2.85x | $25.53 | $3.4M | 246.6K | 80 |
| 2021 | $42.61 | $13.78 | 3.09x | $28.83 | $3.1M | 221.5K | 78 |
| 2022 | $42.90 | $12.72 | 3.37x | $30.18 | $4.3M | 338.6K | 83 |
| 2023 | $44.14 | $12.47 | 3.54x | $31.67 | $5.1M | 406.1K | 84 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 215.6K | $10.8M | $49.97 | 2.40x |
| 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) | 290.8K | $9.4M | $32.21 | 2.42x |
| J3262 | Injection, tocilizumab, 1 mg | 1.2M | $4.5M | $3.87 | 2.58x |
| J1602 | Injection, golimumab, 1 mg, for intravenous use | 255.4K | $3.6M | $14.17 | 4.31x |
| J0897 | Injection, denosumab, 1 mg | 144.5K | $2.1M | $14.47 | 1.91x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 24.1K | $1.9M | $77.16 | 1.93x |
| 82306 | Vitamin d-3 level | 16.4K | $563.3K | $34.42 | 2.46x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 6.0K | $545.0K | $90.60 | 2.76x |
| J1740 | Injection, ibandronate sodium, 1 mg | 5.4K | $388.1K | $71.72 | 3.06x |
| 86235 | Measurement of antibody for assessment of autoimmune disorder, any method | 18.8K | $383.5K | $20.42 | 3.87x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 8.0K | $369.0K | $46.30 | 2.09x |
| 80053 | Blood test, comprehensive group of blood chemicals | 29.3K | $347.1K | $11.83 | 2.81x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 33.9K | $302.3K | $8.93 | 3.13x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 11.7K | $224.0K | $19.10 | 2.46x |
| 86769 | Measure of severe acute respiratory syndrome coronavirus 2 (covid-19) antibody | 5.2K | $215.6K | $41.17 | 6.07x |
| 96415 | Administration of chemotherapy into vein, each additional hour | 10.3K | $210.0K | $20.31 | 6.15x |
| 20610 | Aspiration and/or injection of fluid from large joint | 5.4K | $191.9K | $35.27 | 2.95x |
| 86140 | Measurement c-reactive protein for detection of infection or inflammation | 32.0K | $191.2K | $5.97 | 4.52x |
| 96401 | Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle | 3.3K | $164.7K | $49.67 | 1.47x |
| 95165 | Professional service for preparation and provision of 1 or more antigens | 17.2K | $153.2K | $8.92 | 2.61x |
This provider submits charges 2.76 times higher than what Medicare actually pays.
A markup ratio of 2.76x means for every $100 Medicare pays, this provider initially charges $276. 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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