This provider's $6.9M 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.
Notable: Payments increased 67% 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 | $246.35 | $116.46 | 2.12x | $129.89 | $636.2K | 8.6K | 2.4K |
| 2015 | $216.66 | $108.55 | 2.00x | $108.11 | $1.1M | 12.7K | 3.2K |
| 2016 | $215.98 | $115.48 | 1.87x | $100.50 | $1.1M | 13.3K | 3.2K |
| 2017 | $179.16 | $94.60 | 1.89x | $84.56 | $1.0M | 14.9K | 3.5K |
| 2018 | $255.82 | $122.48 | 2.09x | $133.34 | $717.3K | 11.7K | 3.4K |
| 2019 | $267.49 | $123.87 | 2.16x | $143.62 | $593.1K | 8.8K | 2.7K |
| 2020 | $271.84 | $113.34 | 2.40x | $158.50 | $445.5K | 6.2K | 2.4K |
| 2021 | $302.91 | $102.38 | 2.96x | $200.53 | $428.5K | 5.5K | 2.1K |
| 2022 | $110.22 | $48.23 | 2.29x | $61.99 | $478.3K | 11.0K | 2.8K |
| 2023 | $107.37 | $45.07 | 2.38x | $62.30 | $457.2K | 10.6K | 2.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2505 | Injection, pegfilgrastim, 6 mg | 913 | $2.7M | $3.0K | 1.97x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 13.7K | $1.1M | $82.16 | 2.15x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 8.5K | $426.2K | $50.28 | 2.26x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 4.0K | $404.5K | $101.45 | 2.44x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 2.0K | $255.7K | $128.82 | 2.09x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 15.4K | $226.6K | $14.71 | 2.69x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.6K | $210.2K | $80.61 | 2.04x |
| J9310 | Injection, rituximab, 100 mg | 336 | $198.8K | $591.66 | 1.60x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 3.3K | $184.2K | $55.34 | 2.02x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 4.7K | $107.1K | $22.95 | 2.75x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 662 | $101.2K | $152.86 | 2.09x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 1.8K | $94.7K | $51.37 | 2.22x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 678 | $78.7K | $116.07 | 2.20x |
| J2469 | Injection, palonosetron hcl, 25 mcg | 4.1K | $50.5K | $12.40 | 4.66x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 484 | $50.4K | $104.11 | 2.06x |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | 5.4K | $46.7K | $8.71 | 2.13x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 894 | $43.3K | $48.38 | 2.58x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 241 | $38.2K | $158.36 | 2.07x |
| 96374 | Injection of drug or substance into a vein for therapy, diagnosis, or prevention | 981 | $37.8K | $38.54 | 2.25x |
| G0008 | Administration of influenza virus vaccine | 1.5K | $34.2K | $22.47 | 1.74x |
This provider submits charges 2.16 times higher than what Medicare actually pays.
A markup ratio of 2.16x means for every $100 Medicare pays, this provider initially charges $216. 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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