This provider's $4.3M in total Medicare payments ranks in the 96th 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 | $192.37 | $79.79 | 2.41x | $112.58 | $384.6K | 10.3K | 2.8K |
| 2015 | $191.20 | $74.85 | 2.55x | $116.35 | $420.8K | 11.6K | 3.7K |
| 2016 | $188.61 | $75.97 | 2.48x | $112.64 | $465.4K | 11.4K | 3.9K |
| 2017 | $196.92 | $86.04 | 2.29x | $110.88 | $641.3K | 11.6K | 3.9K |
| 2018 | $194.71 | $86.73 | 2.25x | $107.98 | $702.9K | 11.7K | 3.9K |
| 2019 | $109.36 | $33.37 | 3.28x | $75.99 | $526.5K | 12.9K | 4.3K |
| 2020 | $123.87 | $33.30 | 3.72x | $90.57 | $310.5K | 9.7K | 3.4K |
| 2021 | $117.27 | $30.11 | 3.89x | $87.16 | $310.6K | 9.9K | 3.7K |
| 2022 | $114.50 | $34.44 | 3.32x | $80.06 | $294.7K | 9.3K | 3.8K |
| 2023 | $123.27 | $33.09 | 3.73x | $90.18 | $288.9K | 8.6K | 3.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 8.6K | $725.2K | $84.39 | 3.99x |
| J2505 | Injection, pegfilgrastim, 6 mg | 197 | $627.7K | $3.2K | 1.84x |
| G9678 | Oncology Care Model service | 3.1K | $481.2K | $156.80 | 1.03x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 4.1K | $451.7K | $109.78 | 3.98x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 3.4K | $407.8K | $120.69 | 3.91x |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 1.4K | $230.1K | $159.59 | 3.71x |
| 80053 | Blood test, comprehensive group of blood chemicals | 12.9K | $157.3K | $12.16 | 2.56x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 13.2K | $119.8K | $9.04 | 1.81x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.0K | $115.3K | $56.40 | 4.07x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 634 | $100.7K | $158.76 | 3.86x |
| 84153 | PSA (prostate specific antigen) measurement | 3.9K | $79.8K | $20.68 | 2.38x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 1.1K | $59.0K | $52.48 | 3.97x |
| 96375 | Injection of different drug or substance into a vein for therapy, diagnosis, or prevention | 3.4K | $52.0K | $15.36 | 4.01x |
| J9310 | Injection, rituximab, 100 mg | 81 | $47.4K | $585.79 | 1.75x |
| J1454 | Injection, fosnetupitant 235 mg and palonosetron 0.25 mg | 131 | $41.9K | $319.77 | 2.76x |
| 36415 | Insertion of needle into vein for collection of blood sample | 12.1K | $41.5K | $3.42 | 2.50x |
| 82306 | Vitamin D-3 level | 1.1K | $40.3K | $35.36 | 1.80x |
| 96402 | Hormonal anti-neoplastic chemotherapy administration beneath the skin or into muscle | 1.6K | $40.1K | $24.51 | 4.18x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 710 | $39.1K | $55.03 | 4.26x |
| J2353 | Injection, octreotide, depot form for intramuscular injection, 1 mg | 266 | $36.5K | $137.22 | 1.81x |
This provider submits charges 3.04 times higher than what Medicare actually pays.
A markup ratio of 3.04x means for every $100 Medicare pays, this provider initially charges $304. 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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