Statistical flag only — not an accusation of fraud
⚠️ This provider averages 345 services per working day — physically unusual for an individual practitioner
Based on 862.3K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $14.8M in total Medicare payments ranks in the 99th percentile of Medical Oncology providers nationally.
Averaging 345 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 870% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 74/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 168% in 2018
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 | $63.00 | $16.30 | 3.87x | $46.70 | $365.5K | 22.4K | 21 |
| 2015 | $62.13 | $16.83 | 3.69x | $45.30 | $572.3K | 34.0K | 24 |
| 2016 | $53.21 | $14.97 | 3.55x | $38.24 | $413.3K | 27.6K | 23 |
| 2017 | $35.81 | $10.81 | 3.31x | $25.00 | $571.7K | 52.9K | 23 |
| 2018 | $65.29 | $18.66 | 3.50x | $46.63 | $1.5M | 82.1K | 30 |
| 2019 | $48.47 | $14.04 | 3.45x | $34.43 | $1.5M | 107.3K | 33 |
| 2020 | $58.39 | $16.81 | 3.47x | $41.58 | $2.1M | 123.0K | 32 |
| 2021 | $40.85 | $14.53 | 2.81x | $26.32 | $1.6M | 107.1K | 31 |
| 2022 | $45.52 | $16.70 | 2.73x | $28.82 | $2.6M | 157.7K | 33 |
| 2023 | $57.03 | $23.95 | 2.38x | $33.08 | $3.5M | 148.0K | 33 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 131.5K | $4.9M | $36.99 | 2.85x |
| J0897 | Injection, denosumab, 1 mg | 146.9K | $2.2M | $15.24 | 2.97x |
| J9144 | Injection, daratumumab, 10 mg and hyaluronidase-fihj | 58.0K | $2.2M | $37.25 | 2.23x |
| J2505 | Injection, pegfilgrastim, 6 mg | 392 | $1.2M | $3.1K | 3.58x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 8.6K | $779.5K | $90.56 | 2.23x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 4.6K | $572.0K | $124.83 | 2.76x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 5.7K | $392.0K | $68.94 | 2.11x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 2.4K | $303.5K | $126.25 | 2.15x |
| J2469 | Injection, palonosetron hcl, 25 mcg | 26.0K | $202.5K | $7.79 | 9.42x |
| Q5106 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units | 22.0K | $149.3K | $6.80 | 4.22x |
| Q5107 | Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg | 5.3K | $147.1K | $27.61 | 5.05x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 871 | $147.1K | $168.92 | 2.11x |
| J1439 | Injection, ferric carboxymaltose, 1 mg | 160.7K | $138.5K | $0.86 | 3.71x |
| 96367 | Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less | 5.0K | $136.2K | $27.15 | 2.93x |
| J1453 | Injection, fosaprepitant, 1 mg | 119.4K | $121.8K | $1.02 | 5.97x |
| 96401 | Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle | 1.7K | $118.9K | $69.33 | 1.98x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 10.8K | $96.6K | $8.92 | 3.24x |
| 96372 | Injection of drug or substance under skin or into muscle | 5.6K | $89.3K | $15.95 | 2.83x |
| J2506 | Injection, pegfilgrastim, excludes biosimilar, 0.5 mg | 648 | $82.8K | $127.80 | 4.44x |
| 96417 | Administration of additional new drug or substance into vein, 1 hour or less | 1.3K | $77.4K | $60.20 | 2.67x |
This provider submits charges 3.02 times higher than what Medicare actually pays.
A markup ratio of 3.02x means for every $100 Medicare pays, this provider initially charges $302. 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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