⚠️ This provider averages 424 services per working day — physically unusual for an individual practitioner
Based on 1.1M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $17.8M in total Medicare payments ranks in the 99th percentile of Hematology-Oncology providers nationally.
Averaging 424 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 6956% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 2759% in 2021
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 | $248.56 | $91.21 | 2.73x | $157.35 | $98.3K | 1.1K | 7 |
| 2015 | $254.75 | $92.59 | 2.75x | $162.16 | $94.1K | 1.0K | 7 |
| 2016 | $243.23 | $87.42 | 2.78x | $155.81 | $89.8K | 1.0K | 6 |
| 2017 | $257.33 | $90.67 | 2.84x | $166.66 | $81.7K | 901 | 7 |
| 2018 | $263.35 | $96.90 | 2.72x | $166.45 | $107.8K | 1.1K | 5 |
| 2019 | $262.04 | $97.27 | 2.69x | $164.77 | $138.4K | 1.4K | 8 |
| 2020 | $257.94 | $95.64 | 2.70x | $162.30 | $110.0K | 1.1K | 8 |
| 2021 | $39.31 | $16.36 | 2.40x | $22.95 | $3.1M | 192.2K | 34 |
| 2022 | $42.35 | $16.20 | 2.61x | $26.15 | $7.0M | 433.2K | 43 |
| 2023 | $43.96 | $16.25 | 2.71x | $27.71 | $6.9M | 426.9K | 42 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 170.0K | $6.9M | $40.35 | 2.27x |
| J9144 | Injection, daratumumab, 10 mg and hyaluronidase-fihj | 41.8K | $1.6M | $37.16 | 2.42x |
| J9299 | Injection, nivolumab, 1 mg | 57.0K | $1.2M | $21.24 | 2.30x |
| Q5115 | Injection, rituximab-abbs, biosimilar, (truxima), 10 mg | 25.9K | $1.1M | $40.91 | 1.88x |
| J0897 | Injection, denosumab, 1 mg | 57.7K | $1.0M | $17.52 | 2.23x |
| J1561 | Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg | 19.9K | $728.4K | $36.66 | 2.15x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 4.8K | $571.1K | $118.94 | 2.54x |
| Q5117 | Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg | 16.6K | $529.1K | $31.87 | 2.67x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 5.9K | $527.6K | $89.62 | 2.76x |
| Q5111 | Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg | 3.7K | $496.8K | $135.75 | 3.68x |
| J9041 | Injection, bortezomib (velcade), 0.1 mg | 12.9K | $432.7K | $33.47 | 2.81x |
| Q5107 | Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg | 12.5K | $301.4K | $24.16 | 5.13x |
| J9264 | Injection, paclitaxel protein-bound particles, 1 mg | 27.9K | $273.2K | $9.79 | 2.25x |
| J1459 | Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg | 6.8K | $241.9K | $35.52 | 2.20x |
| J9035 | Injection, bevacizumab, 10 mg | 4.1K | $229.0K | $56.41 | 2.68x |
| J9305 | Injection, pemetrexed, not otherwise specified, 10 mg | 7.5K | $191.9K | $25.71 | 5.06x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 1.3K | $157.9K | $126.22 | 2.64x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 904 | $152.9K | $169.17 | 2.66x |
| Q5106 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units | 19.7K | $124.0K | $6.29 | 3.65x |
| 96417 | Administration of additional new drug or substance into vein, 1 hour or less | 1.9K | $109.9K | $58.12 | 2.53x |
This provider submits charges 2.62 times higher than what Medicare actually pays.
A markup ratio of 2.62x means for every $100 Medicare pays, this provider initially charges $262. 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 MD for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| David Smith, MD | Easton, MD | $48.3M | ✓ Clear |
| Frederick Smith, M.D. | Chevy Chase, MD | $33.7M | ✓ 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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