Statistical flag only — not an accusation of fraud
⚠️ This provider averages 1.4K services per working day — physically unusual for an individual practitioner
Based on 3.4M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $30.3M in total Medicare payments ranks in the 99th percentile of Hematology-Oncology providers nationally.
Averaging 1.4K services per working day raises questions about billing patterns.
This provider has been statistically flagged with a risk score of 71/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 53% 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 | $42.91 | $8.82 | 4.87x | $34.09 | $2.5M | 286.5K | 70 |
| 2015 | $36.15 | $7.89 | 4.58x | $28.26 | $3.1M | 391.7K | 67 |
| 2016 | $36.45 | $8.27 | 4.41x | $28.18 | $3.7M | 448.8K | 70 |
| 2017 | $46.16 | $9.41 | 4.91x | $36.75 | $3.5M | 376.7K | 66 |
| 2018 | $47.37 | $9.62 | 4.92x | $37.75 | $3.0M | 306.9K | 69 |
| 2019 | $46.47 | $8.86 | 5.24x | $37.61 | $2.2M | 248.9K | 69 |
| 2020 | $44.95 | $8.57 | 5.25x | $36.38 | $3.4M | 394.5K | 71 |
| 2021 | $46.04 | $8.75 | 5.26x | $37.29 | $2.7M | 314.0K | 67 |
| 2022 | $50.68 | $10.32 | 4.91x | $40.36 | $3.1M | 298.2K | 69 |
| 2023 | $43.76 | $8.50 | 5.15x | $35.26 | $3.1M | 359.9K | 69 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 134.5K | $5.4M | $40.21 | 3.39x |
| J2505 | Injection, pegfilgrastim, 6 mg | 838 | $2.6M | $3.0K | 4.89x |
| J9035 | Injection, bevacizumab, 10 mg | 44.8K | $2.5M | $56.66 | 3.41x |
| J1568 | Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg | 71.2K | $2.2M | $30.43 | 6.48x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 20.3K | $1.7M | $85.63 | 2.62x |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | 507.6K | $1.5M | $2.89 | 6.89x |
| J9299 | Injection, nivolumab, 1 mg | 69.1K | $1.4M | $20.40 | 3.32x |
| J9310 | Injection, rituximab, 100 mg | 2.3K | $1.4M | $604.10 | 3.45x |
| J0897 | Injection, denosumab, 1 mg | 89.0K | $1.3M | $14.73 | 3.70x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 6.4K | $708.2K | $111.16 | 6.17x |
| Q5107 | Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg | 13.7K | $567.4K | $41.36 | 4.46x |
| Q5119 | Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg | 13.2K | $545.2K | $41.46 | 4.68x |
| J9312 | Injection, rituximab, 10 mg | 7.3K | $524.2K | $72.08 | 3.52x |
| J2353 | Injection, octreotide, depot form for intramuscular injection, 1 mg | 2.8K | $373.9K | $132.98 | 3.58x |
| J1439 | Injection, ferric carboxymaltose, 1 mg | 444.8K | $368.8K | $0.83 | 4.41x |
| J9999 | Not otherwise classified, antineoplastic drugs | 291 | $354.5K | $1.2K | 3.94x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 33.5K | $306.3K | $9.13 | 3.83x |
| Q0138 | Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) | 469.7K | $296.8K | $0.63 | 8.21x |
| 80053 | Blood test, comprehensive group of blood chemicals | 26.3K | $287.6K | $10.94 | 5.67x |
| Q5118 | Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg | 9.2K | $286.1K | $31.21 | 5.32x |
This provider submits charges 4.93 times higher than what Medicare actually pays.
A markup ratio of 4.93x means for every $100 Medicare pays, this provider initially charges $493. 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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