OpenMedicare
Start Here
Explore
Fraud
Investigations
Data
Tools
About

Footer

OpenMedicare

Independent Medicare data journalism

Sister Sites

  • OpenMedicaid
  • OpenFeds
  • OpenSpending

Explore

  • Providers
  • Procedures
  • States
  • Specialties
  • Search

Fraud Analysis

  • Still Out There (AI)
  • Fraud Overview
  • Fraud Watchlist
  • Deep Dive Profiles
  • Impossible Numbers
  • Report Fraud

Investigations

  • The Algorithm Knows
  • How We Built the Model
  • Internal Medicine Crisis
  • Florida & California Fraud
  • Million Dollar Flagged
  • All Investigations

Tools

  • Provider Lookup
  • Compare
  • Cost Calculator
  • Your Medicare Dollar
  • Downloads

About

  • About OpenMedicare
  • Methodology
  • Glossary
  • Data Sources
  • API Docs
  • Updates
Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
Sister Sites: OpenMedicaid · OpenFeds · OpenSpending

© 2026 OpenMedicare. Independent data journalism. Built by TheDataProject.ai

Methodology•Download Data
  1. Home
  2. Providers
  3. James Essell
⚕️
MDIndividual

James Essell, MD

NPI: 1265425078
Cincinnati, OH
10 years of data
Hematopoietic Cell Transplantation and Cellular Therapy
$3.4M
Total Payments
24.0K
Beneficiaries
75.9K
Services
4.02x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$3.4M
Specialty median$91.0K

📋 Key Findings

1Billed $3.4M over 10 years
24.02x markup ratio (above median)
399th percentile in Hematopoietic Cell Transplantation and Cellular Therapy by payments
4Payments surged 80% in 2017
519 procedures with >3x markup
✓ No flags detected

🔎 Data Analysis

This provider's $3.4M in total Medicare payments ranks in the 99th percentile of Hematopoietic Cell Transplantation and Cellular Therapy providers nationally.

This provider's billing patterns fall within normal ranges for their specialty.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

📈

Notable: Payments increased 80% in 2017

Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$355.38$111.473.19x$243.91$280.3K5.5K1.8K
2015$331.38$115.682.86x$215.70$235.2K5.7K1.9K
2016$208.21$51.944.01x$156.27$254.3K6.9K2.2K
2017$546.89$119.944.56x$426.95$456.8K9.2K2.9K
2018$514.53$114.504.49x$400.03$569.3K9.2K2.7K
2019$541.00$115.814.67x$425.19$430.7K8.3K2.4K
2020$182.24$41.064.44x$141.18$354.4K8.6K2.6K
2021$159.51$36.124.42x$123.39$344.9K8.5K2.6K
2022$174.11$37.844.60x$136.27$256.2K7.3K2.6K
2023$172.28$31.115.54x$141.17$210.3K6.7K2.3K

Top Procedures (20)

99214Established patient office or other outpatient, visit typically 25 minutes⚠ 3.7x markup
$743.5K
9.0K services$82.22/svc3.66x markup
J2505Injection, pegfilgrastim, 6 mg⚠ 3.8x markup
$507.2K
159 services$3.2K/svc3.77x markup
G9678Oncology Care Model service
$385.6K
2.4K services$158.04/svc1.01x markup
96413Infusion of chemotherapy into a vein up to 1 hour⚠ 6.7x markup
$309.5K
3.1K services$98.49/svc6.68x markup
99233Subsequent hospital inpatient care, typically 35 minutes per day⚠ 3.6x markup
$260.4K
3.2K services$80.42/svc3.60x markup
99213Established patient office or other outpatient visit, typically 15 minutes⚠ 3.8x markup
$212.6K
4.1K services$51.88/svc3.84x markup
85025Complete blood cell count (red cells, white blood cell, platelets), automated test⚠ 3.7x markup
$112.0K
12.4K services$9.01/svc3.71x markup
99215Established patient office or other outpatient, visit typically 40 minutes⚠ 3.4x markup
$91.3K
773 services$118.06/svc3.39x markup
80053Blood test, comprehensive group of blood chemicals⚠ 5.2x markup
$87.5K
7.8K services$11.25/svc5.21x markup
96365Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour⚠ 5.9x markup
$83.7K
1.7K services$49.89/svc5.87x markup
J9310Injection, rituximab, 100 mg⚠ 3.1x markup
$79.3K
119 services$666.60/svc3.15x markup
99223Initial hospital inpatient care, typically 70 minutes per day⚠ 3.6x markup
$66.1K
438 services$150.96/svc3.60x markup
96401Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle⚠ 3.7x markup
$45.3K
823 services$55.05/svc3.67x markup
96372Injection beneath the skin or into muscle for therapy, diagnosis, or prevention⚠ 6.1x markup
$42.2K
2.9K services$14.38/svc6.11x markup
96367Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour⚠ 6.6x markup
$36.7K
1.7K services$22.09/svc6.56x markup
38222Bone marrow biopsy and aspiration⚠ 5.1x markup
$21.5K
210 services$102.48/svc5.10x markup
99204New patient office or other outpatient visit, typically 45 minutes⚠ 3.6x markup
$20.7K
168 services$123.34/svc3.58x markup
99232Subsequent hospital inpatient care, typically 25 minutes per day⚠ 3.6x markup
$19.0K
341 services$55.80/svc3.60x markup
83615Lactate dehydrogenase (enzyme) level⚠ 5.0x markup
$18.4K
3.5K services$5.25/svc5.01x markup
99239Hospital discharge day management, more than 30 minutes⚠ 3.6x markup
$16.7K
202 services$82.74/svc3.59x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
99214Established patient office or other outpatient, visit typically 25 minutes9.0K$743.5K$82.223.66x
J2505Injection, pegfilgrastim, 6 mg159$507.2K$3.2K3.77x
G9678Oncology Care Model service2.4K$385.6K$158.041.01x
96413Infusion of chemotherapy into a vein up to 1 hour3.1K$309.5K$98.496.68x
99233Subsequent hospital inpatient care, typically 35 minutes per day3.2K$260.4K$80.423.60x
99213Established patient office or other outpatient visit, typically 15 minutes4.1K$212.6K$51.883.84x
85025Complete blood cell count (red cells, white blood cell, platelets), automated test12.4K$112.0K$9.013.71x
99215Established patient office or other outpatient, visit typically 40 minutes773$91.3K$118.063.39x
80053Blood test, comprehensive group of blood chemicals7.8K$87.5K$11.255.21x
96365Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour1.7K$83.7K$49.895.87x
J9310Injection, rituximab, 100 mg119$79.3K$666.603.15x
99223Initial hospital inpatient care, typically 70 minutes per day438$66.1K$150.963.60x
96401Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle823$45.3K$55.053.67x
96372Injection beneath the skin or into muscle for therapy, diagnosis, or prevention2.9K$42.2K$14.386.11x
96367Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour1.7K$36.7K$22.096.56x
38222Bone marrow biopsy and aspiration210$21.5K$102.485.10x
99204New patient office or other outpatient visit, typically 45 minutes168$20.7K$123.343.58x
99232Subsequent hospital inpatient care, typically 25 minutes per day341$19.0K$55.803.60x
83615Lactate dehydrogenase (enzyme) level3.5K$18.4K$5.255.01x
99239Hospital discharge day management, more than 30 minutes202$16.7K$82.743.59x

Markup Analysis

Charge-to-Payment Ratio

4.02x

This provider submits charges 4.02 times higher than what Medicare actually pays.

What This Means

A markup ratio of 4.02x means for every $100 Medicare pays, this provider initially charges $402. This is higher than the national average.

Location

Cincinnati, OH

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

Related

Browse
← Back to Provider Directory
State
All providers in OH →
Specialty
All Hematopoietic Cell Transplantation and Cellular Therapy providers →
Tool
Compare this provider →
Analysis
Fraud Watchlist →
Search
Search all providers →

Share This Provider

Share this provider's Medicare payment information

Share:

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

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.

Believe this data is inaccurate? Dispute this data