Statistical flag only — not an accusation of fraud
⚠️ This provider averages 1.5K services per working day — physically unusual for an individual practitioner
Based on 3.8M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $40.6M in total Medicare payments ranks in the 99th percentile of Hematology-Oncology providers nationally.
Averaging 1.5K services per working day raises questions about billing patterns.
This provider has been statistically flagged with a risk score of 76/100. 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 | $50.27 | $12.81 | 3.92x | $37.46 | $3.2M | 250.2K | 53 |
| 2015 | $40.59 | $11.74 | 3.46x | $28.85 | $3.3M | 279.2K | 50 |
| 2016 | $28.48 | $8.43 | 3.38x | $20.05 | $2.9M | 348.1K | 49 |
| 2017 | $27.92 | $7.99 | 3.49x | $19.93 | $3.1M | 383.6K | 58 |
| 2018 | $35.18 | $10.19 | 3.45x | $24.99 | $3.9M | 387.1K | 54 |
| 2019 | $46.65 | $13.93 | 3.35x | $32.72 | $5.2M | 371.6K | 54 |
| 2020 | $43.93 | $11.77 | 3.73x | $32.16 | $4.5M | 380.7K | 54 |
| 2021 | $45.90 | $9.58 | 4.79x | $36.32 | $5.0M | 524.6K | 51 |
| 2022 | $52.46 | $10.79 | 4.86x | $41.67 | $4.7M | 437.4K | 58 |
| 2023 | $55.95 | $11.47 | 4.88x | $44.48 | $4.7M | 413.0K | 51 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 219.4K | $9.0M | $40.98 | 3.28x |
| J0897 | Injection, denosumab, 1 mg | 226.3K | $3.4M | $14.84 | 3.24x |
| J2505 | Injection, pegfilgrastim, 6 mg | 1.1K | $3.2M | $3.0K | 3.17x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 23.9K | $2.0M | $81.45 | 2.48x |
| J9035 | Injection, bevacizumab, 10 mg | 35.1K | $1.9M | $54.56 | 2.86x |
| J9299 | Injection, nivolumab, 1 mg | 79.9K | $1.8M | $22.22 | 3.32x |
| J9305 | Injection, pemetrexed, not otherwise specified, 10 mg | 34.4K | $1.8M | $51.05 | 2.95x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 17.4K | $1.7M | $99.11 | 4.07x |
| J9022 | Injection, atezolizumab, 10 mg | 26.0K | $1.6M | $61.42 | 3.32x |
| Q5111 | Injection, pegfilgrastim-cbqv, biosimilar, (udenyca), 0.5 mg | 4.3K | $1.1M | $262.50 | 3.31x |
| J9310 | Injection, rituximab, 100 mg | 1.6K | $956.8K | $586.63 | 2.51x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 15.7K | $878.8K | $55.87 | 2.55x |
| Q5120 | Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo), 0.5 mg | 4.0K | $806.1K | $202.33 | 4.34x |
| J9264 | Injection, paclitaxel protein-bound particles, 1 mg | 80.9K | $671.1K | $8.30 | 2.90x |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 7.3K | $579.3K | $79.05 | 2.62x |
| J9355 | Injection, trastuzumab, 10 mg | 7.4K | $563.0K | $75.92 | 2.99x |
| Q5119 | Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg | 13.1K | $454.2K | $34.70 | 5.59x |
| J0641 | Injection, levoleucovorin, not otherwise specified, 0.5 mg | 1.0M | $450.0K | $0.44 | 8.18x |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | 43.0K | $405.3K | $9.42 | 4.21x |
| 96367 | Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less | 17.1K | $382.5K | $22.37 | 5.07x |
This provider submits charges 4 times higher than what Medicare actually pays.
A markup ratio of 4x means for every $100 Medicare pays, this provider initially charges $400. 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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