This provider's $3.3M in total Medicare payments ranks in the 96th percentile of Medical 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 66% 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 | $182.95 | $77.91 | 2.35x | $105.04 | $250.1K | 7.6K | 2.3K |
| 2015 | $82.93 | $26.47 | 3.13x | $56.46 | $247.4K | 8.8K | 2.6K |
| 2016 | $182.75 | $73.70 | 2.48x | $109.05 | $410.1K | 10.4K | 3.8K |
| 2017 | $178.48 | $79.27 | 2.25x | $99.21 | $524.8K | 10.3K | 3.7K |
| 2018 | $180.35 | $79.89 | 2.26x | $100.46 | $493.3K | 12.2K | 3.9K |
| 2019 | $115.48 | $35.70 | 3.23x | $79.78 | $378.8K | 10.5K | 3.2K |
| 2020 | $99.49 | $28.23 | 3.52x | $71.26 | $250.9K | 9.3K | 2.7K |
| 2021 | $98.48 | $25.14 | 3.92x | $73.34 | $252.7K | 9.2K | 2.8K |
| 2022 | $101.64 | $31.11 | 3.27x | $70.53 | $225.2K | 7.5K | 2.7K |
| 2023 | $112.82 | $33.03 | 3.42x | $79.79 | $245.7K | 7.5K | 2.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 8.8K | $749.5K | $85.31 | 3.90x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 4.6K | $504.0K | $109.05 | 4.04x |
| J2505 | Injection, pegfilgrastim, 6 mg | 100 | $317.3K | $3.2K | 1.89x |
| G9678 | Oncology Care Model service | 1.7K | $270.5K | $156.80 | 1.03x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.2K | $133.1K | $61.09 | 4.11x |
| 80053 | Blood test, comprehensive group of blood chemicals | 10.2K | $123.1K | $12.13 | 2.51x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 10.9K | $98.4K | $9.05 | 1.81x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 483 | $77.9K | $161.38 | 3.77x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 603 | $73.2K | $121.35 | 3.98x |
| 96375 | Injection of different drug or substance into a vein for therapy, diagnosis, or prevention | 4.2K | $62.4K | $14.97 | 4.13x |
| J9310 | Injection, rituximab, 100 mg | 92 | $60.1K | $653.22 | 1.79x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 1.1K | $58.4K | $52.33 | 4.07x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 992 | $54.1K | $54.52 | 4.23x |
| G0498 | Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted l | 242 | $48.7K | $201.41 | 1.35x |
| J2353 | Injection, octreotide, depot form for intramuscular injection, 1 mg | 355 | $46.4K | $130.80 | 1.80x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 2.6K | $38.7K | $15.15 | 4.69x |
| J1454 | Injection, fosnetupitant 235 mg and palonosetron 0.25 mg | 108 | $37.6K | $348.17 | 2.86x |
| 96374 | Injection of drug or substance into a vein for therapy, diagnosis, or prevention | 1.0K | $37.4K | $36.45 | 4.31x |
| 36415 | Insertion of needle into vein for collection of blood sample | 8.4K | $28.2K | $3.36 | 2.55x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 1.4K | $26.1K | $18.89 | 2.76x |
This provider submits charges 3.18 times higher than what Medicare actually pays.
A markup ratio of 3.18x means for every $100 Medicare pays, this provider initially charges $318. 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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