Statistical flag only — not an accusation of fraud
⚠️ This provider averages 1.7K services per working day — physically unusual for an individual practitioner
Based on 4.2M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $45.5M in total Medicare payments ranks in the 99th percentile of Hematology-Oncology providers nationally.
Averaging 1.7K services per working day raises questions about billing patterns.
This provider has been statistically flagged with a risk score of 66/100. Statistical flags are not accusations of fraud.
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 | $31.44 | $9.08 | 3.46x | $22.36 | $3.3M | 361.0K | 73 |
| 2015 | $29.30 | $8.93 | 3.28x | $20.37 | $4.4M | 490.7K | 76 |
| 2016 | $29.85 | $8.92 | 3.35x | $20.93 | $4.0M | 445.1K | 71 |
| 2017 | $37.12 | $11.65 | 3.19x | $25.47 | $5.0M | 428.9K | 73 |
| 2018 | $33.91 | $10.21 | 3.32x | $23.70 | $4.3M | 421.1K | 71 |
| 2019 | $33.10 | $10.32 | 3.21x | $22.78 | $5.0M | 487.5K | 73 |
| 2020 | $41.51 | $12.85 | 3.23x | $28.66 | $6.3M | 490.5K | 74 |
| 2021 | $38.54 | $11.14 | 3.46x | $27.40 | $4.6M | 414.0K | 69 |
| 2022 | $44.35 | $13.03 | 3.40x | $31.32 | $4.4M | 336.9K | 59 |
| 2023 | $42.82 | $11.93 | 3.59x | $30.89 | $4.2M | 351.6K | 46 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 229.6K | $9.4M | $40.91 | 3.08x |
| J9299 | Injection, nivolumab, 1 mg | 159.2K | $3.5M | $21.71 | 3.12x |
| J1569 | Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg | 93.6K | $3.1M | $33.56 | 3.01x |
| J9310 | Injection, rituximab, 100 mg | 4.4K | $2.7M | $616.35 | 2.50x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 22.8K | $2.0M | $89.57 | 3.11x |
| J2505 | Injection, pegfilgrastim, 6 mg | 568 | $1.7M | $3.0K | 2.67x |
| J9035 | Injection, bevacizumab, 10 mg | 29.9K | $1.7M | $55.70 | 2.71x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 12.6K | $1.4M | $112.30 | 3.59x |
| J9312 | Injection, rituximab, 10 mg | 18.3K | $1.3M | $73.14 | 3.26x |
| J0897 | Injection, denosumab, 1 mg | 86.1K | $1.2M | $14.06 | 2.86x |
| J9041 | Injection, bortezomib, 0.1 mg | 35.5K | $1.2M | $33.67 | 2.93x |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | 122.4K | $1.1M | $8.59 | 2.76x |
| J9144 | Injection, daratumumab, 10 mg and hyaluronidase-fihj | 22.0K | $816.8K | $37.20 | 2.96x |
| Q5119 | Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg | 16.4K | $745.4K | $45.37 | 4.05x |
| J9355 | Injection, trastuzumab, 10 mg | 9.0K | $636.1K | $70.69 | 2.29x |
| J9395 | Injection, fulvestrant, 25 mg | 9.5K | $580.1K | $61.26 | 3.11x |
| J9047 | Injection, carfilzomib, 1 mg | 18.5K | $533.9K | $28.89 | 2.53x |
| J2353 | Injection, octreotide, depot form for intramuscular injection, 1 mg | 3.9K | $504.8K | $129.78 | 2.07x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 3.5K | $453.0K | $128.43 | 3.06x |
| J2469 | Injection, palonosetron hcl, 25 mcg | 44.3K | $452.1K | $10.21 | 4.40x |
This provider submits charges 3.34 times higher than what Medicare actually pays.
A markup ratio of 3.34x means for every $100 Medicare pays, this provider initially charges $334. 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 FL for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Christopher Lobo, MD | Port Charlotte, FL | $60.5M | ⚠️ Flagged |
| Maen Hussein, M.D. | Tavares, FL | $57.6M | ✓ Clear |
| Vikas Malhotra, M.D. | Spring Hill, FL | $52.8M | ✓ Clear |
| Andrew Lipman, M.D. | Naples, FL | $51.1M | ⚠️ Flagged |
| Syed Zafar, M.D. | Fort Myers, FL | $48.1M | ⚠️ 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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