This provider's $7.2M in total Medicare payments ranks in the 98th 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 | $244.03 | $82.12 | 2.97x | $161.91 | $800.4K | 15.0K | 3.5K |
| 2015 | $271.01 | $90.66 | 2.99x | $180.35 | $996.3K | 18.7K | 4.0K |
| 2016 | $289.06 | $95.88 | 3.01x | $193.18 | $770.7K | 10.1K | 2.5K |
| 2017 | $347.31 | $118.74 | 2.92x | $228.57 | $745.7K | 8.8K | 2.2K |
| 2018 | $337.85 | $118.68 | 2.85x | $219.17 | $959.9K | 9.0K | 2.1K |
| 2019 | $380.15 | $133.31 | 2.85x | $246.84 | $1.0M | 8.0K | 1.9K |
| 2020 | $351.61 | $107.70 | 3.26x | $243.91 | $746.8K | 7.3K | 1.8K |
| 2021 | $365.23 | $97.72 | 3.74x | $267.51 | $563.1K | 6.8K | 1.7K |
| 2022 | $133.20 | $34.47 | 3.86x | $98.73 | $250.4K | 6.1K | 1.7K |
| 2023 | $135.91 | $33.28 | 4.08x | $102.63 | $294.3K | 7.7K | 2.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2505 | Injection, pegfilgrastim, 6 mg | 1.2K | $3.8M | $3.0K | 2.78x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 13.1K | $1.0M | $77.81 | 2.94x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 6.5K | $644.0K | $99.06 | 3.06x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 4.0K | $192.7K | $48.37 | 3.08x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.7K | $184.4K | $111.50 | 2.77x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 969 | $145.5K | $150.11 | 2.95x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 776 | $118.5K | $152.69 | 2.87x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 4.5K | $101.3K | $22.68 | 3.22x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 2.0K | $96.7K | $47.92 | 3.13x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 5.5K | $79.3K | $14.39 | 3.72x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.4K | $76.0K | $55.58 | 2.81x |
| 96375 | Injection of different drug or substance into a vein for therapy, diagnosis, or prevention | 4.9K | $70.7K | $14.39 | 3.41x |
| 96523 | Irrigation of implanted venous access drug delivery device | 3.3K | $59.6K | $17.96 | 2.90x |
| J2469 | Injection, palonosetron hcl, 25 mcg | 4.2K | $50.7K | $11.98 | 6.12x |
| 96415 | Infusion of chemotherapy into a vein | 2.3K | $50.4K | $21.54 | 3.25x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 4.0K | $41.2K | $10.34 | 3.68x |
| J9310 | Injection, rituximab, 100 mg | 67 | $38.9K | $580.31 | 2.75x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 710 | $38.5K | $54.17 | 2.88x |
| 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 | 250 | $30.9K | $123.68 | 4.45x |
| J2506 | Injection, pegfilgrastim, excludes biosimilar, 0.5 mg | 236 | $25.4K | $107.72 | 6.16x |
This provider submits charges 3.03 times higher than what Medicare actually pays.
A markup ratio of 3.03x means for every $100 Medicare pays, this provider initially charges $303. 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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