This provider's $3.8M in total Medicare payments ranks in the 96th percentile of Hematology-Oncology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $109.58 | $39.60 | 2.77x | $69.98 | $384.7K | 12.0K | 3.0K |
| 2015 | $105.50 | $38.09 | 2.77x | $67.41 | $480.7K | 14.6K | 3.4K |
| 2016 | $104.54 | $37.14 | 2.81x | $67.40 | $502.3K | 15.3K | 3.7K |
| 2017 | $100.10 | $40.52 | 2.47x | $59.58 | $443.6K | 12.7K | 3.5K |
| 2018 | $137.15 | $53.99 | 2.54x | $83.16 | $365.8K | 9.2K | 2.8K |
| 2019 | $104.44 | $34.90 | 2.99x | $69.54 | $339.8K | 9.6K | 3.0K |
| 2020 | $99.89 | $35.22 | 2.84x | $64.67 | $311.1K | 9.2K | 2.8K |
| 2021 | $104.89 | $33.40 | 3.14x | $71.49 | $406.7K | 11.1K | 2.9K |
| 2022 | $111.41 | $34.37 | 3.24x | $77.04 | $301.8K | 8.2K | 2.4K |
| 2023 | $113.66 | $36.44 | 3.12x | $77.22 | $303.7K | 8.1K | 2.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 14.5K | $1.2M | $80.71 | 1.92x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 5.8K | $688.7K | $119.34 | 1.76x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 5.7K | $619.3K | $108.71 | 3.50x |
| J9310 | Injection, rituximab, 100 mg | 412 | $249.6K | $605.76 | 1.34x |
| 80053 | Blood test, comprehensive group of blood chemicals | 9.6K | $115.1K | $12.02 | 3.66x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 12.5K | $114.8K | $9.18 | 3.81x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 744 | $112.9K | $151.69 | 2.01x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 3.8K | $92.1K | $23.95 | 4.01x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 1.4K | $71.8K | $51.96 | 3.70x |
| 96375 | Injection of different drug or substance into a vein for therapy, diagnosis, or prevention | 3.7K | $56.1K | $15.21 | 4.47x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.0K | $55.8K | $54.67 | 1.90x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 873 | $47.1K | $53.90 | 3.34x |
| 36415 | Insertion of needle into vein for collection of blood sample | 13.1K | $44.3K | $3.38 | 8.89x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 723 | $43.6K | $60.25 | 1.91x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 2.4K | $38.7K | $16.35 | 2.94x |
| 96411 | Infusion of different chemotherapy drug or substance into a vein | 800 | $38.5K | $48.12 | 3.53x |
| J2469 | Injection, palonosetron hcl, 25 mcg | 3.1K | $35.7K | $11.48 | 4.35x |
| 96415 | Infusion of chemotherapy into a vein | 1.5K | $34.6K | $22.95 | 8.37x |
| 96409 | Infusion of chemotherapy into a vein using push technique | 378 | $32.7K | $86.54 | 3.12x |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 136 | $20.5K | $150.81 | 5.24x |
This provider submits charges 2.69 times higher than what Medicare actually pays.
A markup ratio of 2.69x means for every $100 Medicare pays, this provider initially charges $269. 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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