⚠️ This provider averages 1.8K services per working day — physically unusual for an individual practitioner
Based on 1.8M total services over 4 years (250 working days/year). Learn about impossible service volumes →
This provider's $26.4M in total Medicare payments ranks in the 99th percentile of Gastroenterology providers nationally.
Averaging 1.8K services per working day raises questions about billing patterns.
Medicare payments to this provider grew 121248% from 2019 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 5541% in 2021
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 |
|---|---|---|---|---|---|---|---|
| 2019 | $1.1K | $91.28 | 12.54x | $1.1K | $17.2K | 188 | 5 |
| 2021 | $10.29 | $4.84 | 2.13x | $5.45 | $968.0K | 200.2K | 26 |
| 2022 | $19.98 | $7.77 | 2.57x | $12.21 | $4.6M | 588.3K | 28 |
| 2023 | $46.24 | $19.98 | 2.31x | $26.26 | $20.8M | 1.0M | 30 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2507 | Injection, pegloticase, 1 mg | 1.6K | $4.1M | $2.5K | 2.53x |
| J1303 | Injection, ravulizumab-cwvz, 10 mg | 21.4K | $3.7M | $173.98 | 1.71x |
| J3241 | Injection, teprotumumab-trbw, 10 mg | 10.6K | $2.7M | $256.29 | 1.92x |
| J0897 | Injection, denosumab, 1 mg | 112.6K | $2.0M | $17.86 | 2.51x |
| J3111 | Injection, romosozumab-aqqg, 1 mg | 226.4K | $1.8M | $7.79 | 2.49x |
| J9332 | Injection, efgartigimod alfa-fcab, 2mg | 55.6K | $1.4M | $24.91 | 2.55x |
| J9312 | Injection, rituximab, 10 mg | 17.1K | $1.1M | $64.64 | 2.57x |
| J1561 | Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg | 29.5K | $1.1M | $36.79 | 2.54x |
| J3380 | Injection, vedolizumab, 1 mg | 57.6K | $1.0M | $17.39 | 2.54x |
| J1306 | Injection, inclisiran, 1 mg | 92.0K | $861.3K | $9.36 | 2.51x |
| 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) | 23.1K | $785.1K | $33.95 | 2.56x |
| J1439 | Injection, ferric carboxymaltose, 1 mg | 788.8K | $698.1K | $0.89 | 2.43x |
| J3262 | Injection, tocilizumab, 1 mg | 116.5K | $543.4K | $4.66 | 2.54x |
| J2350 | Injection, ocrelizumab, 1 mg | 10.8K | $511.1K | $47.33 | 2.53x |
| J1602 | Injection, golimumab, 1 mg, for intravenous use | 42.9K | $461.3K | $10.76 | 2.65x |
| J1569 | Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg | 10.9K | $392.0K | $35.86 | 2.52x |
| J2357 | Injection, omalizumab, 5 mg | 10.7K | $320.8K | $29.91 | 2.55x |
| J0875 | Injection, dalbavancin, 5 mg | 24.9K | $304.8K | $12.21 | 2.43x |
| J3245 | Injection, tildrakizumab, 1 mg | 2.6K | $286.5K | $110.20 | 2.52x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 5.6K | $286.0K | $50.81 | 2.69x |
This provider submits charges 2.36 times higher than what Medicare actually pays.
A markup ratio of 2.36x means for every $100 Medicare pays, this provider initially charges $236. 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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