This provider's $6.5M in total Medicare payments ranks in the 98th percentile of Medical Oncology providers nationally.
Their average markup ratio of 5.92x is significantly above the specialty median of 3.6x.
AI-generated analysis based on Medicare payment data.
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 | $598.86 | $98.04 | 6.11x | $500.82 | $849.4K | 11.6K | 3.0K |
| 2015 | $666.87 | $110.34 | 6.04x | $556.53 | $637.9K | 10.9K | 2.9K |
| 2016 | $620.71 | $104.20 | 5.96x | $516.51 | $675.9K | 9.7K | 3.4K |
| 2017 | $744.06 | $130.66 | 5.69x | $613.40 | $614.8K | 8.7K | 3.2K |
| 2018 | $605.24 | $115.58 | 5.24x | $489.66 | $846.8K | 10.2K | 3.5K |
| 2019 | $579.11 | $96.80 | 5.98x | $482.31 | $766.8K | 10.4K | 3.5K |
| 2020 | $687.57 | $108.04 | 6.36x | $579.53 | $667.5K | 8.9K | 3.5K |
| 2021 | $732.19 | $101.77 | 7.19x | $630.42 | $509.0K | 9.2K | 3.4K |
| 2022 | $370.42 | $54.46 | 6.80x | $315.96 | $457.4K | 12.1K | 3.6K |
| 2023 | $385.51 | $54.31 | 7.10x | $331.20 | $505.3K | 12.0K | 3.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2505 | Injection, pegfilgrastim, 6 mg | 897 | $2.7M | $3.0K | 5.14x |
| 78815 | Nuclear medicine study with CT imaging skull base to mid-thigh | 995 | $606.7K | $609.70 | 6.31x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 5.0K | $542.8K | $108.71 | 6.53x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.3K | $472.3K | $88.33 | 5.03x |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 1.0K | $219.8K | $215.50 | 5.99x |
| J9310 | Injection, rituximab, 100 mg | 279 | $172.7K | $618.94 | 6.91x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.6K | $152.8K | $59.54 | 5.08x |
| 80053 | Blood test, comprehensive group of blood chemicals | 10.9K | $131.6K | $12.07 | 7.22x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.0K | $127.5K | $122.13 | 4.85x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 12.2K | $112.7K | $9.23 | 6.94x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 1.9K | $100.7K | $54.23 | 6.90x |
| G6015 | Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session | 334 | $98.0K | $293.39 | 11.06x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 1.8K | $94.0K | $52.81 | 6.72x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 3.7K | $90.2K | $24.34 | 6.50x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 470 | $78.8K | $167.75 | 4.99x |
| Q5122 | Injection, pegfilgrastim-apgf, biosimilar, (nyvepria), 0.5 mg | 390 | $70.3K | $180.31 | 7.54x |
| 74177 | CT scan of abdomen and pelvis with contrast | 374 | $67.2K | $179.62 | 7.24x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 3.9K | $57.6K | $14.78 | 8.61x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 355 | $45.9K | $129.23 | 5.26x |
| 96415 | Infusion of chemotherapy into a vein | 1.6K | $37.2K | $23.25 | 6.56x |
This provider submits charges 5.92 times higher than what Medicare actually pays.
A markup ratio of 5.92x means for every $100 Medicare pays, this provider initially charges $592. 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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