Statistical flag only — not an accusation of fraud
⚠️ This provider averages 917 services per working day — physically unusual for an individual practitioner
Based on 2.3M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $36.6M in total Medicare payments ranks in the 99th percentile of Hematology-Oncology providers nationally.
Averaging 917 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 778% from 2014 to 2023.
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.
Notable: Payments increased 84% in 2016
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 | $67.72 | $21.98 | 3.08x | $45.74 | $777.7K | 35.4K | 23 |
| 2015 | $88.01 | $31.46 | 2.80x | $56.55 | $874.5K | 27.8K | 27 |
| 2016 | $44.79 | $15.91 | 2.82x | $28.88 | $1.6M | 100.9K | 31 |
| 2017 | $75.86 | $19.41 | 3.91x | $56.45 | $2.4M | 124.2K | 31 |
| 2018 | $64.28 | $17.11 | 3.76x | $47.17 | $2.7M | 156.8K | 35 |
| 2019 | $56.00 | $13.71 | 4.08x | $42.29 | $3.5M | 254.6K | 35 |
| 2020 | $54.80 | $13.39 | 4.09x | $41.41 | $5.2M | 390.4K | 40 |
| 2021 | $67.68 | $17.00 | 3.98x | $50.68 | $5.5M | 324.5K | 37 |
| 2022 | $62.38 | $14.33 | 4.35x | $48.05 | $7.2M | 499.0K | 42 |
| 2023 | $88.22 | $17.97 | 4.91x | $70.25 | $6.8M | 379.8K | 41 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 182.6K | $7.7M | $42.21 | 3.11x |
| J9299 | Injection, nivolumab, 1 mg | 250.8K | $5.5M | $21.99 | 3.05x |
| J2505 | Injection, pegfilgrastim, 6 mg | 920 | $2.8M | $3.0K | 3.53x |
| J9144 | Injection, daratumumab, 10 mg and hyaluronidase-fihj | 72.9K | $2.7M | $36.93 | 3.33x |
| J0897 | Injection, denosumab, 1 mg | 151.9K | $2.3M | $15.44 | 3.92x |
| J9145 | Injection, daratumumab, 10 mg | 46.4K | $2.0M | $42.98 | 3.10x |
| J9310 | Injection, rituximab, 100 mg | 2.5K | $1.5M | $619.52 | 2.20x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 10.6K | $1.2M | $112.50 | 5.56x |
| Q5119 | Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg | 23.9K | $1.1M | $44.89 | 4.07x |
| J1568 | Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg | 34.6K | $1.1M | $30.55 | 6.88x |
| J9312 | Injection, rituximab, 10 mg | 14.6K | $1.0M | $69.41 | 3.52x |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | 320.3K | $900.8K | $2.81 | 6.52x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 8.8K | $788.3K | $89.28 | 2.55x |
| J9311 | Injection, rituximab 10 mg and hyaluronidase | 15.9K | $547.2K | $34.37 | 3.43x |
| Q5120 | Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo), 0.5 mg | 2.7K | $470.8K | $175.16 | 4.73x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 7.0K | $397.4K | $57.02 | 2.81x |
| J1454 | Injection, fosnetupitant 235 mg and palonosetron 0.25 mg | 909 | $362.7K | $398.97 | 3.82x |
| J9264 | Injection, paclitaxel protein-bound particles, 1 mg | 25.5K | $250.3K | $9.81 | 3.42x |
| J1439 | Injection, ferric carboxymaltose, 1 mg | 264.0K | $224.9K | $0.85 | 3.79x |
| J9041 | Injection, bortezomib, 0.1 mg | 12.5K | $209.1K | $16.70 | 7.26x |
This provider submits charges 4.13 times higher than what Medicare actually pays.
A markup ratio of 4.13x means for every $100 Medicare pays, this provider initially charges $413. 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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