This provider's $6.4M in total Medicare payments ranks in the 97th percentile of Hematology-Oncology providers nationally.
Medicare payments to this provider grew 951% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 513% in 2015
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 | $267.94 | $79.66 | 3.36x | $188.28 | $55.2K | 701 | 365 |
| 2015 | $381.84 | $187.13 | 2.04x | $194.71 | $338.1K | 4.0K | 1.0K |
| 2016 | $257.33 | $123.55 | 2.08x | $133.78 | $806.9K | 10.1K | 2.4K |
| 2017 | $300.56 | $133.19 | 2.26x | $167.37 | $643.1K | 9.3K | 2.4K |
| 2018 | $325.25 | $128.94 | 2.52x | $196.31 | $765.6K | 10.4K | 2.4K |
| 2019 | $308.85 | $124.20 | 2.49x | $184.65 | $956.4K | 12.0K | 2.9K |
| 2020 | $324.37 | $121.42 | 2.67x | $202.95 | $809.5K | 13.0K | 2.9K |
| 2021 | $297.41 | $91.66 | 3.24x | $205.75 | $859.3K | 14.1K | 3.3K |
| 2022 | $139.60 | $52.20 | 2.67x | $87.40 | $607.2K | 13.5K | 3.2K |
| 2023 | $149.53 | $43.65 | 3.43x | $105.88 | $580.0K | 13.5K | 3.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2505 | Injection, pegfilgrastim, 6 mg | 466 | $1.4M | $3.1K | 2.36x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 9.6K | $853.8K | $88.72 | 2.50x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 5.9K | $780.2K | $131.47 | 2.37x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 7.2K | $683.0K | $94.27 | 2.47x |
| G9678 | Oncology Care Model service | 3.1K | $493.1K | $158.08 | 1.01x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 3.7K | $455.8K | $124.15 | 2.95x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 2.4K | $391.3K | $166.38 | 2.47x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.1K | $151.7K | $71.58 | 2.25x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 2.3K | $145.2K | $61.80 | 2.92x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 5.1K | $137.9K | $27.24 | 4.20x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 15.1K | $129.6K | $8.58 | 3.24x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.8K | $111.6K | $61.31 | 2.57x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 1.3K | $84.7K | $67.11 | 2.63x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 412 | $72.9K | $176.93 | 2.32x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 4.6K | $69.1K | $14.93 | 4.38x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 1.1K | $66.5K | $59.51 | 3.16x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 435 | $58.1K | $133.63 | 2.43x |
| 36415 | Insertion of needle into vein for collection of blood sample | 9.7K | $40.0K | $4.14 | 2.27x |
| J3490 | Unclassified drugs | 3.4K | $25.8K | $7.50 | 3.74x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 336 | $23.3K | $69.42 | 2.13x |
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.
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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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