This provider's $5.2M in total Medicare payments ranks in the 97th percentile of Hematology-Oncology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $211.88 | $83.87 | 2.53x | $128.01 | $555.1K | 13.0K | 4.1K |
| 2015 | $221.84 | $96.83 | 2.29x | $125.01 | $575.5K | 11.6K | 3.6K |
| 2016 | $288.18 | $138.46 | 2.08x | $149.72 | $617.1K | 10.5K | 2.7K |
| 2017 | $292.25 | $148.46 | 1.97x | $143.79 | $559.7K | 9.9K | 2.6K |
| 2018 | $308.10 | $151.68 | 2.03x | $156.42 | $702.6K | 10.6K | 2.7K |
| 2019 | $321.85 | $152.59 | 2.11x | $169.26 | $486.5K | 9.5K | 2.4K |
| 2020 | $134.04 | $54.43 | 2.46x | $79.61 | $363.7K | 9.3K | 2.4K |
| 2021 | $146.62 | $59.17 | 2.48x | $87.45 | $491.1K | 11.1K | 2.6K |
| 2022 | $140.45 | $55.34 | 2.54x | $85.11 | $463.1K | 10.6K | 2.5K |
| 2023 | $133.45 | $52.26 | 2.55x | $81.19 | $359.5K | 8.4K | 2.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 18.5K | $1.8M | $95.71 | 2.35x |
| J2505 | Injection, pegfilgrastim, 6 mg | 366 | $1.2M | $3.2K | 1.80x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 4.3K | $552.2K | $127.64 | 2.74x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 18.7K | $169.5K | $9.05 | 4.42x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.4K | $127.3K | $91.81 | 1.90x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 3.0K | $121.0K | $39.90 | 2.51x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 675 | $119.1K | $176.38 | 2.83x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 1.7K | $104.9K | $62.94 | 3.18x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.6K | $101.6K | $61.93 | 2.02x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 5.1K | $88.7K | $17.26 | 2.90x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 1.4K | $86.9K | $61.47 | 3.25x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 583 | $80.0K | $137.27 | 2.18x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 2.7K | $75.0K | $27.97 | 4.47x |
| 36415 | Insertion of needle into vein for collection of blood sample | 19.3K | $66.0K | $3.42 | 4.38x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 923 | $63.1K | $68.39 | 1.83x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 1.8K | $63.0K | $34.17 | 2.19x |
| 96375 | Injection of different drug or substance into a vein for therapy, diagnosis, or prevention | 3.3K | $57.3K | $17.24 | 4.35x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 289 | $49.9K | $172.69 | 1.59x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 299 | $35.1K | $117.50 | 1.91x |
| Q5111 | Injection, pegfilgrastim-cbqv, biosimilar, (udenyca), 0.5 mg | 116 | $27.1K | $233.80 | 2.14x |
This provider submits charges 2.5 times higher than what Medicare actually pays.
A markup ratio of 2.5x means for every $100 Medicare pays, this provider initially charges $250. 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 NJ for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Bhavesh Balar, MD | Freehold, NJ | $36.9M | ⚠️ 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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