This provider's $5.4M in total Medicare payments ranks in the 97th 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.
Notable: Payments increased 1642% in 2020
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $368.24 | $87.10 | 4.23x | $281.14 | $800.1K | 15.6K | 3.9K |
| 2015 | $345.51 | $85.21 | 4.05x | $260.30 | $1.0M | 17.8K | 4.8K |
| 2016 | $329.27 | $82.38 | 4.00x | $246.89 | $828.2K | 17.5K | 5.1K |
| 2017 | $379.93 | $86.98 | 4.37x | $292.95 | $775.6K | 15.1K | 4.9K |
| 2018 | $428.23 | $95.48 | 4.49x | $332.75 | $655.8K | 12.3K | 4.4K |
| 2019 | $164.04 | $31.31 | 5.24x | $132.73 | $3.6K | 150 | 122 |
| 2020 | $154.34 | $49.71 | 3.10x | $104.63 | $62.5K | 1.1K | 439 |
| 2021 | $294.74 | $91.41 | 3.22x | $203.33 | $425.3K | 5.9K | 1.9K |
| 2022 | $125.22 | $37.94 | 3.30x | $87.28 | $402.0K | 9.2K | 2.7K |
| 2023 | $138.02 | $35.69 | 3.87x | $102.33 | $398.4K | 8.1K | 2.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2505 | Injection, pegfilgrastim, 6 mg | 496 | $1.4M | $2.9K | 4.06x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 9.8K | $808.9K | $82.24 | 3.35x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 6.2K | $745.1K | $120.97 | 3.27x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 6.0K | $616.5K | $103.33 | 4.10x |
| J9310 | Injection, rituximab, 100 mg | 274 | $168.0K | $613.25 | 2.90x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.9K | $149.9K | $80.94 | 3.32x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 14.3K | $141.5K | $9.88 | 3.32x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.5K | $135.7K | $53.71 | 3.48x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 695 | $109.7K | $157.80 | 3.29x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 2.2K | $106.9K | $49.29 | 4.23x |
| J1454 | Injection, fosnetupitant 235 mg and palonosetron 0.25 mg | 213 | $84.5K | $396.94 | 3.26x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 3.4K | $79.6K | $23.21 | 4.48x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 1.4K | $75.4K | $52.68 | 3.90x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 2.8K | $48.5K | $17.25 | 3.47x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 304 | $47.1K | $154.83 | 3.27x |
| 36415 | Insertion of needle into vein for collection of blood sample | 13.1K | $38.8K | $2.97 | 3.34x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 661 | $37.3K | $56.40 | 3.34x |
| 96409 | Infusion of chemotherapy into a vein using push technique | 366 | $31.7K | $86.72 | 4.02x |
| 96375 | Injection of different drug or substance into a vein for therapy, diagnosis, or prevention | 2.3K | $31.1K | $13.70 | 4.11x |
| G6015 | Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session | 94 | $29.6K | $314.91 | 3.87x |
This provider submits charges 3.83 times higher than what Medicare actually pays.
A markup ratio of 3.83x means for every $100 Medicare pays, this provider initially charges $383. 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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