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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Providers
  3. Douglas Heldreth
🎗️
MDIndividual

Douglas Heldreth, M.D.

NPI: 1699766378
Naples, FL
10 years of data
Hematology-Oncology
$35.9M
Total Payments
618
Beneficiaries
3.2M
Services
3.19x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$35.9M
Specialty median$339.6K
Rank #44 of 60 in specialty

📋 Key Findings

1Billed $35.9M over 10 years
23.19x markup ratio (above median)
399th percentile in Hematology-Oncology by payments
41.3K services/day — physically implausible
511 procedures with >3x markup

⚠️ This provider averages 1.3K services per working day — physically unusual for an individual practitioner

Based on 3.2M total services over 10 years (250 working days/year). Learn about impossible service volumes →

🔎 Data Analysis

This provider's $35.9M in total Medicare payments ranks in the 99th percentile of Hematology-Oncology providers nationally.

Averaging 1.3K services per working day raises questions about billing patterns.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$20.97$6.023.48x$14.95$2.5M417.0K72
2015$25.52$7.923.22x$17.60$2.8M348.6K67
2016$31.32$9.493.30x$21.83$3.1M329.1K65
2017$44.73$14.763.03x$29.97$4.0M271.9K66
2018$43.38$13.573.20x$29.81$4.2M308.8K67
2019$34.47$11.153.09x$23.32$4.4M392.5K70
2020$40.65$13.343.05x$27.31$4.0M299.3K56
2021$44.57$14.153.15x$30.42$4.4M311.5K62
2022$37.80$11.413.31x$26.39$3.4M300.5K55
2023$45.97$13.893.31x$32.08$3.1M221.4K38

Top Procedures (20)

J9271Injection, pembrolizumab, 1 mg⚠ 3.1x markup
$7.5M
184.2K services$40.66/svc3.11x markup
G9678Oncology care model (ocm) monthly enhanced oncology services (meos) payment for ocm enhanced services. g9678 payments may only be made to ocm practitioners for ocm beneficiaries for the furnishment of enhanced services as defined in the ocm participation a
$3.6M
22.8K services$158.02/svc2.53x markup
J9299Injection, nivolumab, 1 mg⚠ 3.1x markup
$3.1M
139.8K services$21.94/svc3.11x markup
J9310Injection, rituximab, 100 mg
$2.3M
3.7K services$613.45/svc2.49x markup
J1569Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg⚠ 3.0x markup
$2.2M
66.3K services$33.77/svc3.03x markup
J0897Injection, denosumab, 1 mg
$2.0M
141.7K services$14.21/svc2.84x markup
J2505Injection, pegfilgrastim, 6 mg
$1.7M
549 services$3.1K/svc2.64x markup
99214Established patient office or other outpatient visit, 30-39 minutes⚠ 3.2x markup
$1.2M
14.1K services$87.48/svc3.17x markup
J0885Injection, epoetin alfa, (for non-esrd use), 1000 units
$1.2M
133.2K services$8.92/svc2.68x markup
96413Administration of chemotherapy into vein, 1 hour or less⚠ 3.6x markup
$918.8K
8.2K services$111.98/svc3.60x markup
J9035Injection, bevacizumab, 10 mg
$738.7K
13.1K services$56.56/svc2.66x markup
Q0138Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use)⚠ 3.7x markup
$642.8K
957.3K services$0.67/svc3.74x markup
J9355Injection, trastuzumab, 10 mg
$620.0K
8.7K services$71.68/svc2.47x markup
99213Established patient office or other outpatient visit, 20-29 minutes⚠ 3.1x markup
$569.1K
9.6K services$59.00/svc3.11x markup
J9395Injection, fulvestrant, 25 mg⚠ 3.4x markup
$538.9K
10.0K services$54.15/svc3.42x markup
J9312Injection, rituximab, 10 mg⚠ 3.3x markup
$512.1K
7.1K services$71.83/svc3.29x markup
J9264Injection, paclitaxel protein-bound particles, 1 mg
$376.6K
45.9K services$8.21/svc2.92x markup
J9144Injection, daratumumab, 10 mg and hyaluronidase-fihj
$346.4K
9.2K services$37.74/svc2.91x markup
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count⚠ 3.2x markup
$321.4K
35.1K services$9.15/svc3.17x markup
J1568Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg⚠ 3.1x markup
$319.7K
10.6K services$30.28/svc3.14x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
J9271Injection, pembrolizumab, 1 mg184.2K$7.5M$40.663.11x
G9678Oncology care model (ocm) monthly enhanced oncology services (meos) payment for ocm enhanced services. g9678 payments may only be made to ocm practitioners for ocm beneficiaries for the furnishment of enhanced services as defined in the ocm participation a22.8K$3.6M$158.022.53x
J9299Injection, nivolumab, 1 mg139.8K$3.1M$21.943.11x
J9310Injection, rituximab, 100 mg3.7K$2.3M$613.452.49x
J1569Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg66.3K$2.2M$33.773.03x
J0897Injection, denosumab, 1 mg141.7K$2.0M$14.212.84x
J2505Injection, pegfilgrastim, 6 mg549$1.7M$3.1K2.64x
99214Established patient office or other outpatient visit, 30-39 minutes14.1K$1.2M$87.483.17x
J0885Injection, epoetin alfa, (for non-esrd use), 1000 units133.2K$1.2M$8.922.68x
96413Administration of chemotherapy into vein, 1 hour or less8.2K$918.8K$111.983.60x
J9035Injection, bevacizumab, 10 mg13.1K$738.7K$56.562.66x
Q0138Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use)957.3K$642.8K$0.673.74x
J9355Injection, trastuzumab, 10 mg8.7K$620.0K$71.682.47x
99213Established patient office or other outpatient visit, 20-29 minutes9.6K$569.1K$59.003.11x
J9395Injection, fulvestrant, 25 mg10.0K$538.9K$54.153.42x
J9312Injection, rituximab, 10 mg7.1K$512.1K$71.833.29x
J9264Injection, paclitaxel protein-bound particles, 1 mg45.9K$376.6K$8.212.92x
J9144Injection, daratumumab, 10 mg and hyaluronidase-fihj9.2K$346.4K$37.742.91x
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count35.1K$321.4K$9.153.17x
J1568Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg10.6K$319.7K$30.283.14x

Markup Analysis

Charge-to-Payment Ratio

3.19x

This provider submits charges 3.19 times higher than what Medicare actually pays.

What This Means

A markup ratio of 3.19x means for every $100 Medicare pays, this provider initially charges $319. This is higher than the national average.

Location

Naples, FL

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

Similar Providers

Other Hematology-Oncology providers in FL for peer comparison.

Douglas Heldreth (you)
$35.9M
Christopher Lobo, MD⚠️
$60.5M
Maen Hussein, M.D.
$57.6M
Vikas Malhotra, M.D.
$52.8M
Andrew Lipman, M.D.⚠️
$51.1M
Syed Zafar, M.D.⚠️
$48.1M
Show detailed table ▾
ProviderLocationTotal PaymentsStatus
Christopher Lobo, MDPort Charlotte, FL$60.5M⚠️ Flagged
Maen Hussein, M.D.Tavares, FL$57.6M✓ Clear
Vikas Malhotra, M.D.Spring Hill, FL$52.8M✓ Clear
Andrew Lipman, M.D.Naples, FL$51.1M⚠️ Flagged
Syed Zafar, M.D.Fort Myers, FL$48.1M⚠️ Flagged

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

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.

Believe this data is inaccurate? Dispute this data