This provider's $4.2M 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 | $164.64 | $68.79 | 2.39x | $95.85 | $425.3K | 9.9K | 3.1K |
| 2015 | $163.33 | $69.42 | 2.35x | $93.91 | $414.9K | 9.8K | 3.7K |
| 2016 | $175.26 | $72.66 | 2.41x | $102.60 | $429.3K | 10.7K | 3.7K |
| 2017 | $165.73 | $71.33 | 2.32x | $94.40 | $503.8K | 10.9K | 3.7K |
| 2018 | $176.63 | $78.45 | 2.25x | $98.18 | $671.5K | 11.9K | 4.5K |
| 2019 | $125.99 | $37.48 | 3.36x | $88.51 | $463.4K | 11.9K | 3.9K |
| 2020 | $112.98 | $32.88 | 3.44x | $80.10 | $316.9K | 9.8K | 3.5K |
| 2021 | $113.83 | $30.08 | 3.78x | $83.75 | $340.2K | 9.0K | 3.4K |
| 2022 | $125.96 | $39.56 | 3.18x | $86.40 | $324.4K | 8.4K | 3.4K |
| 2023 | $133.03 | $38.10 | 3.49x | $94.93 | $317.1K | 8.1K | 3.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 9.3K | $805.4K | $86.45 | 4.01x |
| J2505 | Injection, pegfilgrastim, 6 mg | 235 | $725.7K | $3.1K | 1.85x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 5.5K | $592.4K | $108.29 | 4.08x |
| G9678 | Oncology Care Model service | 1.9K | $296.0K | $156.80 | 1.03x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.5K | $182.4K | $123.25 | 3.91x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.9K | $156.4K | $54.11 | 4.04x |
| 80053 | Blood test, comprehensive group of blood chemicals | 10.0K | $121.3K | $12.18 | 2.61x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 10.8K | $98.1K | $9.05 | 1.82x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 586 | $93.2K | $159.12 | 3.79x |
| G0498 | Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted l | 436 | $89.1K | $204.34 | 1.33x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 1.4K | $77.5K | $54.07 | 4.43x |
| J2353 | Injection, octreotide, depot form for intramuscular injection, 1 mg | 544 | $72.6K | $133.52 | 1.86x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 1.4K | $70.7K | $51.96 | 4.02x |
| 96375 | Injection of different drug or substance into a vein for therapy, diagnosis, or prevention | 4.5K | $67.7K | $14.91 | 4.15x |
| J1454 | Injection, fosnetupitant 235 mg and palonosetron 0.25 mg | 155 | $52.3K | $337.47 | 2.76x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 2.9K | $42.5K | $14.55 | 4.89x |
| 96411 | Infusion of different chemotherapy drug or substance into a vein | 734 | $33.3K | $45.37 | 4.20x |
| 96360 | Hydration infusion into a vein 31 minutes to 1 hour | 963 | $31.6K | $32.77 | 5.00x |
| 36415 | Insertion of needle into vein for collection of blood sample | 8.9K | $29.2K | $3.26 | 2.61x |
| 96374 | Injection of drug or substance into a vein for therapy, diagnosis, or prevention | 719 | $27.4K | $38.14 | 4.10x |
This provider submits charges 3.14 times higher than what Medicare actually pays.
A markup ratio of 3.14x means for every $100 Medicare pays, this provider initially charges $314. 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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