⚠️ This provider averages 403 services per working day — physically unusual for an individual practitioner
Based on 302.6K total services over 3 years (250 working days/year). Learn about impossible service volumes →
This provider's $7.7M in total Medicare payments ranks in the 98th percentile of Hematology-Oncology providers nationally.
Averaging 403 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 141% from 2021 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 163% in 2022
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 |
|---|---|---|---|---|---|---|---|
| 2021 | $92.97 | $26.28 | 3.54x | $66.69 | $1.3M | 48.4K | 48 |
| 2022 | $86.73 | $22.43 | 3.87x | $64.30 | $3.3M | 149.1K | 59 |
| 2023 | $103.39 | $29.17 | 3.54x | $74.22 | $3.1M | 105.0K | 54 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 97.0K | $4.1M | $42.77 | 3.27x |
| Q5122 | Injection, pegfilgrastim-apgf, biosimilar, (nyvepria), 0.5 mg | 2.3K | $468.7K | $205.59 | 3.82x |
| J0897 | Injection, denosumab, 1 mg | 23.3K | $407.6K | $17.51 | 3.38x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 3.9K | $366.9K | $94.50 | 2.12x |
| J9173 | Injection, durvalumab, 10 mg | 5.2K | $316.7K | $61.20 | 4.08x |
| Q5118 | Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg | 8.3K | $309.3K | $37.22 | 5.10x |
| Q5127 | Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg | 864 | $233.1K | $269.74 | 4.52x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 2.1K | $201.1K | $97.39 | 4.11x |
| J1454 | Injection, fosnetupitant 235 mg and palonosetron 0.25 mg | 393 | $152.5K | $388.15 | 3.59x |
| G9678 | Oncology care model (ocm) monthly enhanced oncology services (meos) payment for ocm enhanced services. g9678 payments may only be made to ocm practitioners for ocm beneficiaries for the furnishment of enhanced services as defined in the ocm participation a | 671 | $107.2K | $159.81 | 1.04x |
| Q5119 | Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg | 2.4K | $99.8K | $40.87 | 5.51x |
| J1437 | Injection, ferric derisomaltose, 10 mg | 4.0K | $70.6K | $17.65 | 4.25x |
| 80053 | Blood test, comprehensive group of blood chemicals | 6.3K | $65.8K | $10.36 | 4.15x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 6.6K | $50.1K | $7.63 | 4.59x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 318 | $38.2K | $120.19 | 2.50x |
| 96375 | Injection of additional new drug or substance into vein | 3.2K | $36.5K | $11.54 | 8.66x |
| Q5108 | Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg | 360 | $36.0K | $99.90 | 9.26x |
| G0498 | Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted l | 191 | $34.0K | $178.05 | 14.88x |
| J0185 | Injection, aprepitant, 1 mg | 23.8K | $31.8K | $1.34 | 4.43x |
| 36415 | Insertion of needle into vein for collection of blood sample | 6.0K | $30.2K | $5.08 | 1.97x |
This provider submits charges 3.68 times higher than what Medicare actually pays.
A markup ratio of 3.68x means for every $100 Medicare pays, this provider initially charges $368. 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 AL for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| John Waples, M.D. | Huntsville, AL | $76.5M | ⚠️ Flagged |
| Marshall Schreeder, M.D. | Huntsville, AL | $37.8M | ✓ 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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