Statistical flag only — not an accusation of fraud
⚠️ This provider averages 384 services per working day — physically unusual for an individual practitioner
Based on 960.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $18.7M in total Medicare payments ranks in the 99th percentile of Medical Oncology providers nationally.
Averaging 384 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 584% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 70/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 116% in 2015
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 | $32.52 | $11.43 | 2.85x | $21.09 | $506.9K | 44.3K | 23 |
| 2015 | $28.94 | $10.69 | 2.71x | $18.25 | $1.1M | 102.6K | 28 |
| 2016 | $41.70 | $15.07 | 2.77x | $26.63 | $1.1M | 72.4K | 26 |
| 2017 | $58.68 | $21.91 | 2.68x | $36.77 | $1.3M | 57.2K | 25 |
| 2018 | $33.88 | $12.98 | 2.61x | $20.90 | $1.6M | 123.3K | 27 |
| 2019 | $53.04 | $19.44 | 2.73x | $33.60 | $1.7M | 86.1K | 26 |
| 2020 | $57.39 | $20.63 | 2.78x | $36.76 | $2.5M | 120.7K | 31 |
| 2021 | $127.40 | $20.81 | 6.12x | $106.59 | $2.3M | 110.6K | 31 |
| 2022 | $147.63 | $25.02 | 5.90x | $122.61 | $3.2M | 128.4K | 28 |
| 2023 | $171.47 | $30.13 | 5.69x | $141.34 | $3.5M | 115.0K | 28 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 156.6K | $6.4M | $40.87 | 4.27x |
| J9144 | Injection, daratumumab, 10 mg and hyaluronidase-fihj | 49.0K | $1.8M | $37.41 | 5.17x |
| J2505 | Injection, pegfilgrastim, 6 mg | 461 | $1.4M | $3.0K | 2.69x |
| J0897 | Injection, denosumab, 1 mg | 88.4K | $1.3M | $14.60 | 3.32x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 12.4K | $1.1M | $88.83 | 4.75x |
| J9299 | Injection, nivolumab, 1 mg | 39.0K | $901.2K | $23.11 | 5.18x |
| J9310 | Injection, rituximab, 100 mg | 1.3K | $871.4K | $645.97 | 2.28x |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | 263.4K | $774.0K | $2.94 | 3.42x |
| J9145 | Injection, daratumumab, 10 mg | 16.2K | $707.6K | $43.62 | 2.64x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 4.0K | $522.6K | $131.85 | 4.50x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 4.3K | $514.4K | $120.95 | 5.05x |
| J9312 | Injection, rituximab, 10 mg | 6.1K | $452.8K | $73.75 | 3.24x |
| J9035 | Injection, bevacizumab, 10 mg | 3.9K | $216.4K | $55.63 | 2.64x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 2.4K | $143.3K | $59.02 | 4.29x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 710 | $121.1K | $170.61 | 4.98x |
| J9041 | Injection, bortezomib, 0.1 mg | 3.1K | $112.4K | $36.50 | 2.52x |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 1.3K | $111.7K | $87.04 | 4.59x |
| J2506 | Injection, pegfilgrastim, excludes biosimilar, 0.5 mg | 792 | $103.2K | $130.31 | 12.18x |
| J2469 | Injection, palonosetron hcl, 25 mcg | 11.2K | $101.1K | $9.06 | 7.07x |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 583 | $89.2K | $152.92 | 14.08x |
This provider submits charges 4.24 times higher than what Medicare actually pays.
A markup ratio of 4.24x means for every $100 Medicare pays, this provider initially charges $424. 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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