⚠️ This provider averages 1.6K services per working day — physically unusual for an individual practitioner
Based on 3.9M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $31.0M in total Medicare payments ranks in the 99th percentile of Hematology-Oncology providers nationally.
Averaging 1.6K services per working day raises questions about billing patterns.
Medicare payments to this provider grew 475% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 69% 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 | $22.02 | $7.11 | 3.10x | $14.91 | $850.8K | 119.6K | 22 |
| 2015 | $19.14 | $6.41 | 2.99x | $12.73 | $1.1M | 172.3K | 29 |
| 2016 | $23.37 | $8.00 | 2.92x | $15.37 | $1.9M | 233.7K | 32 |
| 2017 | $26.60 | $9.41 | 2.83x | $17.19 | $3.0M | 313.9K | 36 |
| 2018 | $17.99 | $6.47 | 2.78x | $11.52 | $3.1M | 486.3K | 33 |
| 2019 | $21.65 | $7.43 | 2.91x | $14.22 | $3.7M | 501.0K | 35 |
| 2020 | $24.50 | $8.01 | 3.06x | $16.49 | $3.8M | 478.6K | 39 |
| 2021 | $23.34 | $7.86 | 2.97x | $15.48 | $3.6M | 455.6K | 37 |
| 2022 | $23.94 | $8.28 | 2.89x | $15.66 | $5.0M | 608.8K | 38 |
| 2023 | $25.11 | $8.80 | 2.85x | $16.31 | $4.9M | 555.5K | 38 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 177.2K | $7.3M | $41.38 | 2.46x |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | 1.2M | $3.4M | $2.91 | 2.76x |
| J0897 | Injection, denosumab, 1 mg | 188.4K | $2.9M | $15.51 | 2.51x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 18.9K | $1.7M | $89.91 | 4.14x |
| J2505 | Injection, pegfilgrastim, 6 mg | 541 | $1.6M | $3.0K | 2.80x |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 33.4K | $1.5M | $45.55 | 3.45x |
| J9299 | Injection, nivolumab, 1 mg | 54.0K | $1.3M | $23.38 | 2.48x |
| Q0138 | Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) | 1.5M | $1.0M | $0.68 | 3.13x |
| J9310 | Injection, rituximab, 100 mg | 1.5K | $977.8K | $642.05 | 2.57x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 6.7K | $760.7K | $112.80 | 4.33x |
| J9041 | Injection, bortezomib, 0.1 mg | 20.8K | $752.7K | $36.13 | 2.61x |
| J1459 | Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg | 23.8K | $729.0K | $30.65 | 2.57x |
| J1569 | Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg | 20.7K | $728.1K | $35.17 | 2.73x |
| J0129 | Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) | 20.1K | $704.6K | $35.10 | 2.74x |
| J1566 | Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg | 11.4K | $556.3K | $48.71 | 2.56x |
| J2796 | Injection, romiplostim, 10 micrograms | 6.0K | $442.5K | $73.21 | 2.25x |
| J3380 | Injection, vedolizumab, 1 mg | 25.8K | $422.7K | $16.38 | 2.56x |
| J9312 | Injection, rituximab, 10 mg | 5.6K | $416.8K | $74.43 | 2.56x |
| J9355 | Injection, trastuzumab, 10 mg | 3.7K | $278.3K | $75.32 | 2.56x |
| J2506 | Injection, pegfilgrastim, excludes biosimilar, 0.5 mg | 2.4K | $260.6K | $110.25 | 4.13x |
This provider submits charges 2.91 times higher than what Medicare actually pays.
A markup ratio of 2.91x means for every $100 Medicare pays, this provider initially charges $291. This is higher 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 Hematology-Oncology providers in MD for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| David Smith, MD | Easton, MD | $48.3M | ✓ Clear |
| Frederick Smith, M.D. | Chevy Chase, MD | $33.7M | ✓ Clear |
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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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