This provider's $6.5M in total Medicare payments ranks in the 97th percentile of Hematology-Oncology providers nationally.
Their average markup ratio of 5.19x is significantly above the specialty median of 3.5x.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 153% in 2016
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 | $352.72 | $93.07 | 3.79x | $259.65 | $297.6K | 4.9K | 2.1K |
| 2015 | $347.43 | $99.94 | 3.48x | $247.49 | $478.6K | 7.8K | 2.9K |
| 2016 | $679.46 | $143.08 | 4.75x | $536.38 | $1.2M | 14.7K | 4.8K |
| 2017 | $437.91 | $101.51 | 4.31x | $336.40 | $1.1M | 12.9K | 4.3K |
| 2018 | $361.85 | $99.59 | 3.63x | $262.26 | $999.9K | 12.5K | 4.1K |
| 2019 | $394.59 | $97.54 | 4.05x | $297.05 | $693.4K | 7.8K | 3.0K |
| 2020 | $416.34 | $80.41 | 5.18x | $335.93 | $614.0K | 8.8K | 3.3K |
| 2021 | $364.43 | $57.98 | 6.29x | $306.45 | $461.2K | 9.0K | 3.5K |
| 2022 | $236.65 | $39.98 | 5.92x | $196.67 | $340.1K | 9.4K | 3.4K |
| 2023 | $240.90 | $38.05 | 6.33x | $202.85 | $329.7K | 9.4K | 3.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2505 | Injection, pegfilgrastim, 6 mg | 827 | $2.4M | $2.9K | 2.61x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 6.1K | $785.5K | $128.81 | 7.69x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 9.3K | $615.5K | $66.11 | 3.61x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.5K | $414.6K | $92.83 | 3.95x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.8K | $231.5K | $132.05 | 4.16x |
| J3490 | Unclassified drugs | 1.3K | $170.9K | $131.08 | 8.68x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 15.8K | $142.0K | $8.98 | 6.41x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 4.2K | $119.3K | $28.13 | 22.91x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 637 | $111.0K | $174.25 | 6.12x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 1.6K | $110.1K | $70.41 | 4.23x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 1.6K | $104.3K | $63.52 | 10.77x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 5.9K | $98.7K | $16.60 | 6.77x |
| J9310 | Injection, rituximab, 100 mg | 152 | $95.8K | $630.49 | 1.81x |
| J9999 | Not otherwise classified, antineoplastic drugs | 30 | $92.9K | $3.1K | 4.56x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 1.4K | $87.0K | $61.99 | 9.44x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 863 | $77.0K | $89.26 | 3.47x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.2K | $76.1K | $62.53 | 4.73x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 440 | $74.4K | $169.14 | 3.62x |
| G0498 | Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/other outpatient setting using office/other outpatient setting pump/supplies, with continuation of the infusion in the community setting (e.g., home, domicili | 506 | $73.6K | $145.51 | 5.16x |
| 96411 | Infusion of different chemotherapy drug or substance into a vein | 748 | $41.9K | $55.99 | 8.33x |
This provider submits charges 5.19 times higher than what Medicare actually pays.
A markup ratio of 5.19x means for every $100 Medicare pays, this provider initially charges $519. 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 NJ for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Bhavesh Balar, MD | Freehold, NJ | $36.9M | ⚠️ Flagged |
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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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