This provider's $3.7M in total Medicare payments ranks in the 95th 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.
Notable: Payments increased 72% in 2017
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 | $252.15 | $127.00 | 1.99x | $125.15 | $441.4K | 7.8K | 2.2K |
| 2015 | $338.92 | $166.44 | 2.04x | $172.48 | $434.9K | 7.2K | 2.2K |
| 2016 | $101.40 | $41.96 | 2.42x | $59.44 | $281.2K | 8.1K | 2.3K |
| 2017 | $350.76 | $192.84 | 1.82x | $157.92 | $483.4K | 7.5K | 2.2K |
| 2018 | $364.90 | $205.75 | 1.77x | $159.15 | $402.3K | 7.5K | 2.2K |
| 2019 | $384.54 | $176.49 | 2.18x | $208.05 | $405.4K | 7.5K | 2.4K |
| 2020 | $103.58 | $44.00 | 2.35x | $59.58 | $292.8K | 8.4K | 2.3K |
| 2021 | $120.64 | $56.23 | 2.15x | $64.41 | $346.8K | 9.7K | 2.7K |
| 2022 | $127.67 | $51.89 | 2.46x | $75.78 | $286.0K | 9.1K | 2.5K |
| 2023 | $132.44 | $53.82 | 2.46x | $78.62 | $295.6K | 9.2K | 2.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 11.0K | $925.4K | $84.21 | 1.79x |
| J2505 | Injection, pegfilgrastim, 6 mg | 237 | $731.2K | $3.1K | 1.81x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 5.0K | $423.1K | $85.28 | 1.84x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 3.5K | $416.6K | $118.71 | 2.50x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 18.7K | $167.2K | $8.93 | 1.79x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.4K | $157.8K | $64.98 | 1.92x |
| J9310 | Injection, rituximab, 100 mg | 196 | $126.4K | $644.95 | 1.58x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 736 | $116.0K | $157.58 | 1.77x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 534 | $83.9K | $157.08 | 1.96x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 5.4K | $80.3K | $14.75 | 3.05x |
| 36415 | Insertion of needle into vein for collection of blood sample | 16.7K | $60.2K | $3.60 | 2.78x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 974 | $56.9K | $58.37 | 2.54x |
| 96374 | Injection of drug or substance into a vein for therapy, diagnosis, or prevention | 977 | $38.2K | $39.12 | 2.27x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 252 | $31.2K | $123.77 | 2.02x |
| 96415 | Infusion of chemotherapy into a vein | 1.1K | $28.4K | $25.51 | 2.74x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 1.0K | $27.4K | $26.63 | 2.20x |
| 96375 | Injection of different drug or substance into a vein for therapy, diagnosis, or prevention | 1.7K | $27.0K | $16.25 | 3.01x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 349 | $20.8K | $59.74 | 3.08x |
| Q5108 | Injection, pegfilgrastim-jmdb, biosimilar, (fulphila), 0.5 mg | 147 | $19.8K | $134.51 | 3.09x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 287 | $15.9K | $55.25 | 2.12x |
This provider submits charges 2.06 times higher than what Medicare actually pays.
A markup ratio of 2.06x means for every $100 Medicare pays, this provider initially charges $206. 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 CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Luke Dreisbach, M.D. | Rancho Mirage, CA | $77.2M | ✓ Clear |
| Sachin Gupta, M.D. | Fresno, CA | $55.1M | ✓ Clear |
| Ravi Rao, MD | Fresno, CA | $49.1M | ⚠️ Flagged |
| Michael Sherman, M.D., PHD | Walnut Creek, CA | $38.9M | ✓ Clear |
| Nerses Tchekmedyian, M.D. | Irvine, CA | $38.0M | ✓ 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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