⚠️ This provider averages 1.2K services per working day — physically unusual for an individual practitioner
Based on 3.1M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $33.5M in total Medicare payments ranks in the 99th percentile of Medical Oncology providers nationally.
Averaging 1.2K services per working day raises questions about billing patterns.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 54% in 2023
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 | $32.68 | $10.75 | 3.04x | $21.93 | $3.3M | 306.9K | 5.1K |
| 2015 | $32.19 | $10.75 | 2.99x | $21.44 | $2.2M | 204.9K | 3.4K |
| 2016 | $30.09 | $10.75 | 2.80x | $19.34 | $3.2M | 293.8K | 4.9K |
| 2017 | $36.32 | $10.75 | 3.38x | $25.57 | $3.2M | 298.7K | 5.0K |
| 2018 | $37.13 | $10.75 | 3.45x | $26.38 | $2.8M | 261.5K | 4.3K |
| 2019 | $19.14 | $10.75 | 1.78x | $8.39 | $3.2M | 301.7K | 5.0K |
| 2020 | $24.80 | $10.75 | 2.31x | $14.05 | $3.9M | 367.1K | 6.1K |
| 2021 | $26.14 | $10.75 | 2.43x | $15.39 | $4.2M | 390.8K | 6.5K |
| 2022 | $16.14 | $10.75 | 1.50x | $5.39 | $2.9M | 272.5K | 4.5K |
| 2023 | $30.03 | $10.75 | 2.79x | $19.28 | $4.5M | 420.8K | 7.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office/outpatient visit, low complexity | 451.9K | $7.1M | $15.65 | 2.40x |
| 99214 | Office/outpatient visit, moderate complexity | 325.7K | $5.5M | $16.77 | 1.97x |
| 99203 | Office/outpatient visit, new patient | 279.1K | $2.9M | $10.33 | 2.55x |
| 36415 | Insertion of needle into vein for blood collection | 332.1K | $2.5M | $7.64 | 2.90x |
| 99215 | Office/outpatient visit, high complexity | 94.3K | $1.9M | $19.77 | 2.30x |
| 80053 | Comprehensive metabolic panel | 133.5K | $1.6M | $12.23 | 3.67x |
| 85025 | Complete blood cell count | 190.4K | $1.5M | $8.03 | 3.39x |
| 71046 | Chest X-ray, 2 views | 182.8K | $1.4M | $7.75 | 3.86x |
| 93000 | Electrocardiogram with interpretation | 157.7K | $1.3M | $8.23 | 3.63x |
| 96372 | Therapeutic injection | 109.5K | $1.1M | $10.26 | 2.87x |
This provider submits charges 2 times higher than what Medicare actually pays.
A markup ratio of 2x means for every $100 Medicare pays, this provider initially charges $200. This is lower 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.
Other Medical Oncology providers in IL for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Philip Dy, M.D. | Effingham, IL | $52.8M | ✓ Clear |
| Mary Mulcahy, MD | Chicago, IL | $38.2M | ⚠️ Flagged |
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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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