Statistical flag only — not an accusation of fraud
This provider's $1.4M in total Medicare payments ranks in the 88th percentile of Hematology-Oncology providers nationally.
Their average markup ratio of 28.8x is significantly above the specialty median of 3.5x.
Medicare payments to this provider grew 77% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 67/100. Statistical flags are not accusations of fraud.
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 | $459.94 | $15.97 | 28.80x | $443.97 | $97.2K | 6.1K | 245 |
| 2015 | $459.94 | $15.97 | 28.80x | $443.97 | $105.5K | 6.6K | 266 |
| 2016 | $459.94 | $15.97 | 28.80x | $443.97 | $113.9K | 7.1K | 287 |
| 2017 | $459.94 | $15.97 | 28.80x | $443.97 | $122.2K | 7.7K | 308 |
| 2018 | $459.94 | $15.97 | 28.80x | $443.97 | $130.5K | 8.2K | 329 |
| 2019 | $459.94 | $15.97 | 28.80x | $443.97 | $138.9K | 8.7K | 350 |
| 2020 | $459.94 | $15.97 | 28.80x | $443.97 | $147.2K | 9.2K | 371 |
| 2021 | $459.94 | $15.97 | 28.80x | $443.97 | $155.5K | 9.7K | 392 |
| 2022 | $459.94 | $15.97 | 28.80x | $443.97 | $163.8K | 10.3K | 413 |
| 2023 | $459.94 | $15.97 | 28.80x | $443.97 | $172.2K | 10.8K | 434 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Office/outpatient visit, est patient, low | 29.7K | $474.1K | $15.97 | 30.03x |
| 99214 | Office/outpatient visit, est patient, moderate | 14.8K | $237.0K | $15.97 | 28.46x |
| 99215 | Office/outpatient visit, est patient, high | 9.9K | $158.0K | $15.97 | 32.77x |
| 99223 | Initial hospital care, high complexity | 7.4K | $118.5K | $15.97 | 28.04x |
| 99232 | Subsequent hospital care, moderate | 5.9K | $94.8K | $15.97 | 25.79x |
| 93000 | Electrocardiogram, complete | 4.9K | $79.0K | $15.97 | 30.34x |
| 71046 | Chest X-ray, 2 views | 4.2K | $67.7K | $15.97 | 31.62x |
| 80053 | Comprehensive metabolic panel | 3.7K | $59.3K | $15.97 | 29.85x |
| 85025 | Complete blood count (CBC) | 3.3K | $52.7K | $15.97 | 23.51x |
| 36415 | Venipuncture | 3.0K | $47.4K | $15.97 | 29.68x |
This provider submits charges 28.8 times higher than what Medicare actually pays.
A markup ratio of 28.8x means for every $100 Medicare pays, this provider initially charges $2880. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Hematology-Oncology providers in IL for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Pramern Sriratana, M.D. | Normal, IL | $33.5M | ✓ Clear |
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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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