This provider's $4.6M in total Medicare payments ranks in the 96th percentile of Hematology-Oncology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 71% in 2017
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 | $249.86 | $80.41 | 3.11x | $169.45 | $415.2K | 11.4K | 4.4K |
| 2015 | $205.47 | $69.47 | 2.96x | $136.00 | $438.8K | 12.0K | 4.4K |
| 2016 | $236.42 | $88.98 | 2.66x | $147.44 | $332.9K | 10.1K | 3.7K |
| 2017 | $211.56 | $81.00 | 2.61x | $130.56 | $568.3K | 12.5K | 4.5K |
| 2018 | $253.82 | $100.33 | 2.53x | $153.49 | $601.1K | 11.7K | 4.6K |
| 2019 | $201.63 | $83.38 | 2.42x | $118.25 | $499.4K | 11.6K | 4.8K |
| 2020 | $189.19 | $67.83 | 2.79x | $121.36 | $527.2K | 11.9K | 5.4K |
| 2021 | $204.99 | $59.32 | 3.46x | $145.67 | $531.5K | 13.3K | 6.0K |
| 2022 | $102.16 | $31.56 | 3.24x | $70.60 | $386.4K | 14.7K | 6.7K |
| 2023 | $109.90 | $26.75 | 4.11x | $83.15 | $320.4K | 12.8K | 5.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2505 | Injection, pegfilgrastim, 6 mg | 631 | $1.9M | $3.0K | 2.52x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 7.0K | $577.9K | $82.94 | 3.20x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 3.4K | $343.2K | $99.88 | 3.24x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.6K | $192.7K | $118.44 | 3.04x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.9K | $149.7K | $51.20 | 3.38x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 17.1K | $125.4K | $7.32 | 4.22x |
| 80053 | Blood test, comprehensive group of blood chemicals | 11.6K | $115.5K | $9.94 | 4.15x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.3K | $70.8K | $54.49 | 2.70x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 461 | $70.1K | $151.97 | 2.84x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 4.9K | $68.7K | $13.96 | 3.28x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 1.2K | $59.6K | $48.94 | 3.38x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 1.0K | $55.2K | $54.58 | 2.79x |
| 83615 | Lactate dehydrogenase (enzyme) level | 9.2K | $48.6K | $5.27 | 4.38x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 970 | $47.0K | $48.42 | 3.90x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 283 | $44.3K | $156.68 | 2.96x |
| 36415 | Insertion of needle into vein for collection of blood sample | 12.3K | $43.4K | $3.53 | 2.75x |
| 96375 | Injection of different drug or substance into a vein for therapy, diagnosis, or prevention | 3.0K | $40.5K | $13.66 | 4.37x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 338 | $39.5K | $116.75 | 3.10x |
| 96416 | Prolonged chemotherapy infusion into a vein by portable or implanted pump more than 8 hours | 369 | $36.9K | $100.03 | 3.44x |
| J9310 | Injection, rituximab, 100 mg | 56 | $34.7K | $619.24 | 3.20x |
This provider submits charges 3.01 times higher than what Medicare actually pays.
A markup ratio of 3.01x means for every $100 Medicare pays, this provider initially charges $301. 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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