This provider's $4.8M in total Medicare payments ranks in the 99th percentile of Hematology 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 | $112.67 | $61.31 | 1.84x | $51.36 | $417.5K | 8.0K | 2.1K |
| 2015 | $91.71 | $47.56 | 1.93x | $44.15 | $360.8K | 7.5K | 1.8K |
| 2016 | $87.18 | $43.65 | 2.00x | $43.53 | $380.2K | 8.6K | 2.0K |
| 2017 | $109.57 | $64.64 | 1.70x | $44.93 | $330.4K | 6.0K | 1.7K |
| 2018 | $431.68 | $212.67 | 2.03x | $219.01 | $415.2K | 5.7K | 1.6K |
| 2019 | $205.87 | $73.74 | 2.79x | $132.13 | $583.4K | 7.8K | 2.1K |
| 2020 | $268.11 | $77.86 | 3.44x | $190.25 | $615.9K | 8.4K | 2.0K |
| 2021 | $389.98 | $95.53 | 4.08x | $294.45 | $634.5K | 7.4K | 2.1K |
| 2022 | $501.71 | $114.54 | 4.38x | $387.17 | $490.3K | 5.0K | 1.6K |
| 2023 | $436.66 | $109.66 | 3.98x | $327.00 | $559.2K | 5.8K | 1.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 78815 | Nuclear medicine study with CT imaging skull base to mid-thigh | 834 | $1.1M | $1.3K | 3.63x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 9.8K | $851.6K | $87.13 | 2.44x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 5.7K | $659.4K | $115.72 | 2.88x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 3.0K | $258.9K | $84.98 | 2.27x |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 828 | $197.0K | $237.96 | 3.56x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.2K | $191.8K | $60.14 | 2.51x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.5K | $181.8K | $119.24 | 2.13x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 1.0K | $169.7K | $163.82 | 2.31x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 2.2K | $126.5K | $57.12 | 2.50x |
| J2505 | Injection, pegfilgrastim, 6 mg | 27 | $96.4K | $3.6K | 1.67x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 586 | $94.6K | $161.47 | 2.25x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 1.7K | $92.1K | $55.51 | 2.73x |
| G0498 | Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted l | 573 | $82.1K | $143.30 | 2.82x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 3.0K | $77.6K | $25.73 | 2.88x |
| J1454 | Injection, fosnetupitant 235 mg and palonosetron 0.25 mg | 165 | $65.5K | $396.98 | 5.05x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 4.1K | $64.5K | $15.91 | 2.56x |
| 96415 | Infusion of chemotherapy into a vein | 2.0K | $48.9K | $24.50 | 3.15x |
| J9310 | Injection, rituximab, 100 mg | 76 | $45.6K | $600.65 | 1.30x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 4.3K | $38.4K | $8.99 | 2.60x |
| 96411 | Infusion of different chemotherapy drug or substance into a vein | 720 | $36.5K | $50.70 | 2.99x |
This provider submits charges 2.9 times higher than what Medicare actually pays.
A markup ratio of 2.9x means for every $100 Medicare pays, this provider initially charges $290. 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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