Statistical flag only — not an accusation of fraud
⚠️ This provider averages 1.2K services per working day — physically unusual for an individual practitioner
Based on 2.1M total services over 7 years (250 working days/year). Learn about impossible service volumes →
This provider's $15.6M in total Medicare payments ranks in the 99th percentile of Hematology-Oncology providers nationally.
Their average markup ratio of 5.14x is significantly above the specialty median of 3.5x.
Averaging 1.2K services per working day raises questions about billing patterns.
Medicare payments to this provider grew 361% from 2017 to 2023.
This provider has been statistically flagged with a risk score of 69/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 298% in 2018
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 |
|---|---|---|---|---|---|---|---|
| 2017 | $30.22 | $4.38 | 6.90x | $25.84 | $677.7K | 154.9K | 41 |
| 2018 | $35.13 | $5.48 | 6.41x | $29.65 | $2.7M | 492.5K | 62 |
| 2019 | $26.34 | $4.80 | 5.49x | $21.54 | $1.6M | 329.1K | 51 |
| 2020 | $36.14 | $7.67 | 4.71x | $28.47 | $2.3M | 294.5K | 49 |
| 2021 | $39.48 | $8.25 | 4.79x | $31.23 | $2.6M | 313.3K | 63 |
| 2022 | $57.22 | $12.35 | 4.63x | $44.87 | $2.7M | 218.8K | 56 |
| 2023 | $54.87 | $12.18 | 4.50x | $42.69 | $3.1M | 256.5K | 56 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 98.6K | $4.1M | $41.31 | 3.27x |
| J9299 | Injection, nivolumab, 1 mg | 68.0K | $1.5M | $22.65 | 3.31x |
| J0897 | Injection, denosumab, 1 mg | 84.3K | $1.3M | $15.96 | 3.50x |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | 112.7K | $925.5K | $8.21 | 7.35x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 9.2K | $775.4K | $84.58 | 2.62x |
| 78815 | Nuclear medicine study from skull base to mid-thigh with ct scan | 720 | $509.3K | $707.37 | 8.56x |
| Q0138 | Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) | 532.4K | $411.7K | $0.77 | 7.48x |
| J1437 | Injection, ferric derisomaltose, 10 mg | 22.7K | $399.6K | $17.60 | 4.26x |
| J1569 | Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg | 10.6K | $369.7K | $34.87 | 3.44x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 6.4K | $364.3K | $56.91 | 3.08x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 3.6K | $363.2K | $101.09 | 4.47x |
| J2505 | Injection, pegfilgrastim, 6 mg | 96 | $339.3K | $3.5K | 2.49x |
| J9312 | Injection, rituximab, 10 mg | 4.2K | $306.9K | $72.55 | 2.41x |
| J9035 | Injection, bevacizumab, 10 mg | 3.6K | $226.1K | $61.95 | 3.49x |
| J9310 | Injection, rituximab, 100 mg | 309 | $217.2K | $702.96 | 2.48x |
| Q5108 | Injection, pegfilgrastim-jmdb, biosimilar, (fulphila), 0.5 mg | 888 | $207.4K | $233.51 | 3.21x |
| J9041 | Injection, bortezomib (velcade), 0.1 mg | 4.8K | $171.5K | $36.04 | 3.47x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 1.4K | $171.2K | $123.52 | 3.01x |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 766 | $152.5K | $199.15 | 5.48x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 18.4K | $152.3K | $8.26 | 11.02x |
This provider submits charges 5.14 times higher than what Medicare actually pays.
A markup ratio of 5.14x means for every $100 Medicare pays, this provider initially charges $514. 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 SC for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Renwick Goldberg, MD | Myrtle Beach, SC | $38.6M | ⚠️ Flagged |
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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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