This provider averages 55 services per working day
Based on 138.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $21.8M in total Medicare payments ranks in the 99th percentile of Medical Oncology providers nationally.
Averaging 55 services per working day raises questions about billing patterns.
100% of their billing comes from a single procedure code (G9678 — Oncology Care Model service).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 2973% in 2016
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 | $211.97 | $38.09 | 5.56x | $173.88 | $4.1K | 92 | 70 |
| 2015 | $389.73 | $97.85 | 3.98x | $291.88 | $8.4K | 94 | 63 |
| 2016 | $398.00 | $100.89 | 3.94x | $297.11 | $257.4K | 1.7K | 1.0K |
| 2017 | $397.86 | $105.74 | 3.76x | $292.12 | $3.3M | 21.3K | 3.5K |
| 2018 | $415.00 | $120.65 | 3.44x | $294.35 | $4.4M | 28.0K | 3.8K |
| 2019 | $365.00 | $109.40 | 3.34x | $255.60 | $4.6M | 29.2K | 4.2K |
| 2020 | $285.00 | $93.88 | 3.04x | $191.12 | $4.3M | 27.1K | 4.0K |
| 2021 | $267.50 | $121.11 | 2.21x | $146.39 | $4.0M | 25.2K | 3.9K |
| 2022 | $267.50 | $121.12 | 2.21x | $146.38 | $951.2K | 6.0K | 2.1K |
| 2023 | $375.00 | $60.22 | 6.23x | $314.78 | $1.1K | 18 | 16 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| G9678 | Oncology Care Model service | 137.7K | $21.8M | $158.07 | 1.01x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 515 | $33.3K | $64.58 | 5.53x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 188 | $11.5K | $61.01 | 4.07x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 59 | $10.1K | $172.01 | 3.97x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 77 | $6.9K | $89.37 | 3.97x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 41 | $5.8K | $141.70 | 5.01x |
| 99238 | Hospital discharge day management, 30 minutes or less | 30 | $1.8K | $61.56 | 4.01x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 15 | $1.4K | $91.36 | 5.42x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 12 | $358.88 | $29.91 | 5.52x |
This provider submits charges 1.02 times higher than what Medicare actually pays.
A markup ratio of 1.02x means for every $100 Medicare pays, this provider initially charges $102. 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 TX for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| James Uyeki, M.D. | Austin, TX | $35.1M | ⚠️ 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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