⚠️ This provider averages 1.1K services per working day — physically unusual for an individual practitioner
Based on 2.9M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $37.8M in total Medicare payments ranks in the 99th percentile of Hematology-Oncology providers nationally.
Averaging 1.1K services per working day raises questions about billing patterns.
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 | $32.38 | $10.87 | 2.98x | $21.51 | $3.8M | 351.8K | 74 |
| 2015 | $30.12 | $10.38 | 2.90x | $19.74 | $4.2M | 404.9K | 74 |
| 2016 | $31.50 | $10.56 | 2.98x | $20.94 | $5.1M | 480.9K | 82 |
| 2017 | $32.00 | $9.90 | 3.23x | $22.10 | $3.7M | 375.6K | 69 |
| 2018 | $48.42 | $16.07 | 3.01x | $32.35 | $3.6M | 226.2K | 64 |
| 2019 | $48.76 | $15.10 | 3.23x | $33.66 | $3.1M | 208.4K | 64 |
| 2020 | $43.14 | $11.89 | 3.63x | $31.25 | $3.7M | 308.4K | 62 |
| 2021 | $62.57 | $17.67 | 3.54x | $44.90 | $3.4M | 191.1K | 57 |
| 2022 | $75.09 | $20.43 | 3.68x | $54.66 | $3.7M | 180.0K | 54 |
| 2023 | $89.00 | $24.14 | 3.69x | $64.86 | $3.5M | 143.4K | 56 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 164.6K | $6.7M | $40.63 | 3.45x |
| J2505 | Injection, pegfilgrastim, 6 mg | 1.5K | $4.4M | $3.0K | 1.98x |
| J9299 | Injection, nivolumab, 1 mg | 169.5K | $3.8M | $22.29 | 3.59x |
| J9310 | Injection, rituximab, 100 mg | 3.2K | $1.9M | $609.96 | 1.64x |
| J0897 | Injection, denosumab, 1 mg | 111.0K | $1.6M | $14.08 | 3.28x |
| J1568 | Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg | 40.4K | $1.2M | $30.48 | 3.28x |
| J9355 | Injection, trastuzumab, 10 mg | 16.4K | $1.2M | $73.77 | 2.85x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 10.4K | $1.1M | $108.23 | 2.67x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 12.7K | $1.0M | $82.07 | 2.56x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 9.7K | $932.8K | $96.38 | 3.22x |
| J9035 | Injection, bevacizumab, 10 mg | 16.6K | $885.0K | $53.32 | 1.94x |
| 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 | 5.5K | $870.5K | $157.39 | 1.02x |
| J2353 | Injection, octreotide, depot form for intramuscular injection, 1 mg | 5.8K | $761.0K | $131.88 | 1.45x |
| J9395 | Injection, fulvestrant, 25 mg | 13.2K | $645.8K | $48.92 | 2.56x |
| J9264 | Injection, paclitaxel protein-bound particles, 1 mg | 81.9K | $637.7K | $7.79 | 1.93x |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | 209.1K | $608.1K | $2.91 | 3.44x |
| J9041 | Injection, bortezomib (velcade), 0.1 mg | 14.9K | $538.6K | $36.21 | 3.31x |
| J2469 | Injection, palonosetron hcl, 25 mcg | 41.6K | $529.6K | $12.73 | 4.19x |
| Q5122 | Injection, pegfilgrastim-apgf, biosimilar, (nyvepria), 0.5 mg | 2.1K | $427.2K | $201.15 | 3.90x |
| J9305 | Injection, pemetrexed, 10 mg | 9.0K | $417.7K | $46.64 | 1.51x |
This provider submits charges 3.27 times higher than what Medicare actually pays.
A markup ratio of 3.27x means for every $100 Medicare pays, this provider initially charges $327. 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 |
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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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