Statistical flag only — not an accusation of fraud
⚠️ This provider averages 1.3K services per working day — physically unusual for an individual practitioner
Based on 3.3M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $34.3M in total Medicare payments ranks in the 99th percentile of Medical Oncology providers nationally.
Averaging 1.3K services per working day raises questions about billing patterns.
Medicare payments to this provider grew 51% from 2014 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.
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 | $30.49 | $11.19 | 2.72x | $19.30 | $2.3M | 203.6K | 60 |
| 2015 | $29.94 | $11.15 | 2.69x | $18.79 | $2.5M | 228.6K | 57 |
| 2016 | $31.75 | $12.21 | 2.60x | $19.54 | $3.5M | 287.2K | 59 |
| 2017 | $24.71 | $8.87 | 2.79x | $15.84 | $3.2M | 363.4K | 51 |
| 2018 | $25.87 | $9.18 | 2.82x | $16.69 | $4.6M | 498.3K | 53 |
| 2019 | $36.72 | $12.61 | 2.91x | $24.11 | $4.4M | 349.9K | 57 |
| 2020 | $35.45 | $11.38 | 3.12x | $24.07 | $3.1M | 268.6K | 45 |
| 2021 | $33.79 | $12.22 | 2.77x | $21.57 | $4.0M | 323.7K | 54 |
| 2022 | $27.44 | $9.41 | 2.92x | $18.03 | $3.3M | 346.2K | 54 |
| 2023 | $23.01 | $7.87 | 2.92x | $15.14 | $3.4M | 437.1K | 47 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 217.5K | $8.8M | $40.35 | 1.87x |
| J0897 | Injection, denosumab, 1 mg | 263.3K | $3.7M | $14.00 | 2.71x |
| J9299 | Injection, nivolumab, 1 mg | 135.0K | $2.9M | $21.39 | 2.34x |
| J9310 | Injection, rituximab, 100 mg | 3.2K | $1.9M | $599.13 | 1.76x |
| J2505 | Injection, pegfilgrastim, 6 mg | 484 | $1.5M | $3.1K | 1.84x |
| J9355 | Injection, trastuzumab, 10 mg | 20.9K | $1.5M | $71.63 | 1.91x |
| J9035 | Injection, bevacizumab, 10 mg | 25.0K | $1.4M | $55.68 | 1.76x |
| J9022 | Injection, atezolizumab, 10 mg | 19.8K | $1.2M | $61.24 | 2.04x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 11.6K | $1.2M | $100.89 | 5.05x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 17.5K | $953.6K | $54.56 | 2.54x |
| J1439 | Injection, ferric carboxymaltose, 1 mg | 1.0M | $893.5K | $0.85 | 5.86x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 8.6K | $691.3K | $80.09 | 2.63x |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | 227.8K | $650.7K | $2.86 | 2.80x |
| J2469 | Injection, palonosetron hcl, 25 mcg | 50.6K | $524.6K | $10.37 | 5.30x |
| Q5111 | Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg | 2.8K | $494.5K | $178.39 | 2.52x |
| Q5115 | Injection, rituximab-abbs, biosimilar, (truxima), 10 mg | 9.3K | $479.7K | $51.53 | 2.91x |
| J1930 | Injection, lanreotide, 1 mg | 8.5K | $460.3K | $54.03 | 1.85x |
| J9312 | Injection, rituximab, 10 mg | 5.6K | $416.3K | $74.47 | 2.01x |
| J9395 | Injection, fulvestrant, 25 mg | 5.4K | $352.2K | $64.86 | 1.85x |
| J9305 | Injection, pemetrexed, 10 mg | 6.9K | $322.5K | $47.01 | 1.70x |
This provider submits charges 2.83 times higher than what Medicare actually pays.
A markup ratio of 2.83x means for every $100 Medicare pays, this provider initially charges $283. 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.
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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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