This provider's $3.4M in total Medicare payments ranks in the 95th 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.
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 | $271.87 | $147.76 | 1.84x | $124.11 | $315.2K | 4.8K | 2.0K |
| 2015 | $278.45 | $145.71 | 1.91x | $132.74 | $431.6K | 5.3K | 2.1K |
| 2016 | $278.94 | $156.15 | 1.79x | $122.79 | $424.7K | 5.9K | 2.3K |
| 2017 | $270.94 | $152.98 | 1.77x | $117.96 | $396.1K | 6.0K | 2.3K |
| 2018 | $476.74 | $157.11 | 3.03x | $319.63 | $449.1K | 5.7K | 2.3K |
| 2019 | $542.63 | $122.14 | 4.44x | $420.49 | $385.5K | 7.0K | 2.7K |
| 2020 | $548.14 | $108.52 | 5.05x | $439.62 | $318.8K | 7.4K | 2.8K |
| 2021 | $599.30 | $96.64 | 6.20x | $502.66 | $322.4K | 6.3K | 2.4K |
| 2022 | $175.61 | $43.83 | 4.01x | $131.78 | $208.8K | 5.2K | 2.2K |
| 2023 | $172.77 | $36.81 | 4.69x | $135.96 | $158.0K | 4.6K | 1.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2505 | Injection, pegfilgrastim, 6 mg | 358 | $1.1M | $3.0K | 2.91x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.4K | $588.4K | $91.42 | 2.35x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 2.6K | $303.7K | $116.58 | 4.64x |
| G9678 | Oncology Care Model service | 1.1K | $174.0K | $156.80 | 1.02x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 2.4K | $147.5K | $60.24 | 2.53x |
| J9310 | Injection, rituximab, 100 mg | 221 | $136.1K | $615.69 | 1.68x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 901 | $116.4K | $129.13 | 2.24x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 965 | $110.2K | $114.24 | 2.12x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 12.3K | $108.2K | $8.78 | 3.39x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 1.7K | $107.3K | $63.89 | 2.71x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 1.3K | $77.1K | $58.11 | 4.43x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 534 | $71.3K | $133.53 | 2.37x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 2.8K | $44.3K | $15.75 | 4.83x |
| 96375 | Injection of different drug or substance into a vein for therapy, diagnosis, or prevention | 2.4K | $38.2K | $15.64 | 5.68x |
| J3490 | Unclassified drugs | 780 | $37.3K | $47.76 | 2.94x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 557 | $30.9K | $55.43 | 2.55x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 482 | $27.6K | $57.17 | 4.66x |
| 36415 | Insertion of needle into vein for collection of blood sample | 7.1K | $20.9K | $2.94 | 4.50x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 770 | $19.6K | $25.52 | 5.36x |
| 96415 | Infusion of chemotherapy into a vein | 723 | $17.5K | $24.15 | 5.33x |
This provider submits charges 2.99 times higher than what Medicare actually pays.
A markup ratio of 2.99x means for every $100 Medicare pays, this provider initially charges $299. 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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