This provider's $7.2M in total Medicare payments ranks in the 98th percentile of Hematology-Oncology providers nationally.
Their average markup ratio of 5.17x is significantly above the specialty median of 3.5x.
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 | $327.88 | $100.63 | 3.26x | $227.25 | $630.0K | 9.4K | 3.6K |
| 2015 | $1.5K | $190.83 | 7.74x | $1.3K | $762.0K | 8.9K | 3.3K |
| 2016 | $671.42 | $102.69 | 6.54x | $568.73 | $930.3K | 13.7K | 4.6K |
| 2017 | $699.02 | $110.38 | 6.33x | $588.64 | $767.0K | 14.6K | 4.5K |
| 2018 | $674.99 | $113.08 | 5.97x | $561.91 | $927.2K | 13.6K | 3.9K |
| 2019 | $731.92 | $117.86 | 6.21x | $614.06 | $680.1K | 11.4K | 3.1K |
| 2020 | $543.01 | $120.66 | 4.50x | $422.35 | $684.0K | 12.2K | 3.3K |
| 2021 | $359.25 | $92.34 | 3.89x | $266.91 | $860.2K | 16.4K | 4.6K |
| 2022 | $211.84 | $56.70 | 3.74x | $155.14 | $488.0K | 13.1K | 4.1K |
| 2023 | $373.06 | $121.09 | 3.08x | $251.97 | $489.0K | 10.8K | 4.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2505 | Injection, pegfilgrastim, 6 mg | 881 | $2.7M | $3.0K | 5.58x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 4.7K | $568.9K | $120.48 | 5.42x |
| 78815 | Nuclear medicine study with CT imaging skull base to mid-thigh | 411 | $546.5K | $1.3K | 5.11x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.0K | $453.5K | $90.13 | 3.78x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.2K | $337.8K | $65.59 | 3.92x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 2.3K | $295.3K | $127.63 | 3.70x |
| J9310 | Injection, rituximab, 100 mg | 266 | $161.6K | $607.67 | 6.53x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 15.7K | $142.4K | $9.08 | 4.24x |
| 80053 | Blood test, comprehensive group of blood chemicals | 11.4K | $138.5K | $12.14 | 3.45x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 7.7K | $123.4K | $15.96 | 6.99x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 1.9K | $113.4K | $59.01 | 5.80x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 4.1K | $107.4K | $26.32 | 5.69x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 1.6K | $105.4K | $66.18 | 5.88x |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 444 | $103.6K | $233.39 | 9.21x |
| J9999 | Not otherwise classified, antineoplastic drugs | 21 | $96.4K | $4.6K | 9.07x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 503 | $86.0K | $171.03 | 3.81x |
| 82664 | Electrophoresis, laboratory testing technique | 1.5K | $81.1K | $55.56 | 2.68x |
| J3590 | Unclassified biologics | 21 | $76.1K | $3.6K | 2.73x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 1.2K | $72.6K | $58.38 | 5.44x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 401 | $65.0K | $162.20 | 3.85x |
This provider submits charges 5.17 times higher than what Medicare actually pays.
A markup ratio of 5.17x means for every $100 Medicare pays, this provider initially charges $517. 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 Hematology-Oncology providers in CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Luke Dreisbach, M.D. | Rancho Mirage, CA | $77.2M | ✓ Clear |
| Sachin Gupta, M.D. | Fresno, CA | $55.1M | ✓ Clear |
| Ravi Rao, MD | Fresno, CA | $49.1M | ⚠️ Flagged |
| Michael Sherman, M.D., PHD | Walnut Creek, CA | $38.9M | ✓ Clear |
| Nerses Tchekmedyian, M.D. | Irvine, CA | $38.0M | ✓ 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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