This provider averages 54 services per working day
Based on 134.4K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $8.0M in total Medicare payments ranks in the 98th percentile of Hematology-Oncology providers nationally.
Averaging 54 services per working day raises questions about billing patterns.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 66% 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 | $268.39 | $132.72 | 2.02x | $135.67 | $443.3K | 4.8K | 954 |
| 2015 | $228.35 | $109.55 | 2.08x | $118.80 | $736.7K | 9.1K | 1.8K |
| 2016 | $222.57 | $113.26 | 1.97x | $109.31 | $1.1M | 12.5K | 1.9K |
| 2017 | $245.49 | $128.26 | 1.91x | $117.23 | $1.2M | 13.3K | 2.4K |
| 2018 | $269.28 | $139.27 | 1.93x | $130.01 | $1.4M | 14.2K | 2.6K |
| 2019 | $139.11 | $44.41 | 3.13x | $94.70 | $587.5K | 14.7K | 2.3K |
| 2020 | $155.78 | $53.19 | 2.93x | $102.59 | $772.6K | 18.8K | 2.4K |
| 2021 | $157.30 | $60.97 | 2.58x | $96.33 | $736.4K | 17.0K | 2.2K |
| 2022 | $158.10 | $55.31 | 2.86x | $102.79 | $583.6K | 14.8K | 2.1K |
| 2023 | $129.27 | $43.56 | 2.97x | $85.71 | $511.8K | 15.2K | 2.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2505 | Injection, pegfilgrastim, 6 mg | 762 | $2.4M | $3.1K | 1.40x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 8.6K | $1.1M | $132.35 | 3.02x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.5K | $624.6K | $96.56 | 2.59x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 5.6K | $513.9K | $92.15 | 2.66x |
| 99358 | Prolonged patient service without direct patient contact first hour | 3.6K | $339.3K | $92.97 | 2.42x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 2.0K | $263.2K | $131.58 | 2.59x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 8.2K | $238.1K | $28.87 | 3.46x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.3K | $230.0K | $68.95 | 2.46x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 3.4K | $217.3K | $64.32 | 2.33x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.1K | $191.1K | $175.18 | 2.65x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 2.8K | $177.1K | $63.66 | 3.14x |
| 96375 | Injection of different drug or substance into a vein for therapy, diagnosis, or prevention | 10.4K | $175.9K | $16.88 | 4.45x |
| Q5111 | Injection, pegfilgrastim-cbqv, biosimilar, (udenyca), 0.5 mg | 753 | $166.3K | $220.89 | 3.93x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 9.6K | $155.0K | $16.07 | 2.80x |
| 96409 | Infusion of chemotherapy into a vein using push technique | 1.4K | $150.9K | $106.50 | 2.77x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 2.0K | $140.2K | $69.99 | 2.29x |
| 96368 | Infusion into a vein for therapy, prevention, or diagnosis, concurrent with another infusion | 6.7K | $129.3K | $19.25 | 3.90x |
| J3490 | Unclassified drugs | 3.7K | $113.4K | $30.63 | 4.04x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 553 | $98.7K | $178.51 | 2.69x |
| 96415 | Infusion of chemotherapy into a vein | 2.3K | $64.6K | $27.69 | 3.43x |
This provider submits charges 2.52 times higher than what Medicare actually pays.
A markup ratio of 2.52x means for every $100 Medicare pays, this provider initially charges $252. 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 VA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Thomas Alberico, MD | Norfolk, VA | $38.5M | ⚠️ Flagged |
| Mark Fleming, MD | Hampton, VA | $37.6M | ⚠️ 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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