⚠️ This provider averages 658 services per working day — physically unusual for an individual practitioner
Based on 1.6M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $18.2M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Averaging 658 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 301% 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 | $22.39 | $12.48 | 1.79x | $9.91 | $734.5K | 58.9K | 17 |
| 2015 | $25.51 | $13.91 | 1.83x | $11.60 | $987.4K | 71.0K | 20 |
| 2016 | $25.30 | $14.43 | 1.75x | $10.87 | $1.3M | 88.1K | 22 |
| 2017 | $21.47 | $11.00 | 1.95x | $10.47 | $1.2M | 111.3K | 18 |
| 2018 | $23.80 | $12.59 | 1.89x | $11.21 | $1.5M | 122.5K | 17 |
| 2019 | $28.50 | $12.30 | 2.32x | $16.20 | $2.0M | 158.9K | 18 |
| 2020 | $27.43 | $12.61 | 2.18x | $14.82 | $2.1M | 167.3K | 22 |
| 2021 | $24.56 | $10.71 | 2.29x | $13.85 | $2.9M | 268.8K | 22 |
| 2022 | $26.73 | $10.11 | 2.64x | $16.62 | $2.6M | 256.6K | 22 |
| 2023 | $23.63 | $8.61 | 2.74x | $15.02 | $2.9M | 341.8K | 24 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 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) | 1.1M | $5.9M | $5.20 | 2.32x |
| 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) | 104.9K | $4.0M | $37.78 | 1.95x |
| J0897 | Injection, denosumab, 1 mg | 135.6K | $2.1M | $15.53 | 2.14x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 18.5K | $1.7M | $91.98 | 2.53x |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 19.9K | $914.9K | $46.04 | 2.42x |
| 96401 | Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle | 7.2K | $507.1K | $70.13 | 2.23x |
| J3111 | Injection, romosozumab-aqqg, 1 mg | 64.4K | $478.4K | $7.43 | 2.09x |
| J9310 | Injection, rituximab, 100 mg | 814 | $474.2K | $582.50 | 1.31x |
| J3262 | Injection, tocilizumab, 1 mg | 107.7K | $447.2K | $4.15 | 2.31x |
| J1602 | Injection, golimumab, 1 mg, for intravenous use | 22.7K | $374.8K | $16.52 | 2.73x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 2.6K | $336.6K | $128.19 | 2.85x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 1.8K | $234.9K | $130.81 | 2.29x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.4K | $183.2K | $134.28 | 2.73x |
| 20610 | Aspiration and/or injection of fluid from large joint | 3.0K | $168.1K | $56.79 | 3.07x |
| J3304 | Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg | 9.2K | $126.4K | $13.77 | 2.17x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1.9K | $116.3K | $62.02 | 2.52x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 267 | $34.1K | $127.68 | 2.53x |
| 96415 | Administration of chemotherapy into vein, each additional hour | 1.3K | $34.0K | $26.29 | 5.15x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 490 | $29.3K | $59.90 | 4.67x |
| J3489 | Injection, zoledronic acid, 1 mg | 1.5K | $25.6K | $17.44 | 8.62x |
This provider submits charges 2.26 times higher than what Medicare actually pays.
A markup ratio of 2.26x means for every $100 Medicare pays, this provider initially charges $226. 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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