⚠️ This provider averages 1.0K services per working day — physically unusual for an individual practitioner
Based on 2.0M total services over 8 years (250 working days/year). Learn about impossible service volumes →
This provider's $18.2M in total Medicare payments ranks in the 99th percentile of Hematology-Oncology providers nationally.
Averaging 1.0K services per working day raises questions about billing patterns.
Medicare payments to this provider grew 1160% from 2016 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 714% in 2020
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 |
|---|---|---|---|---|---|---|---|
| 2016 | $52.45 | $8.63 | 6.08x | $43.82 | $432.2K | 50.1K | 33 |
| 2017 | $37.29 | $7.00 | 5.33x | $30.29 | $2.1M | 302.1K | 56 |
| 2018 | $156.37 | $59.01 | 2.65x | $97.36 | $56.2K | 952 | 9 |
| 2019 | $16.06 | $4.83 | 3.33x | $11.23 | $237.8K | 49.3K | 22 |
| 2020 | $19.20 | $5.89 | 3.26x | $13.31 | $1.9M | 328.9K | 39 |
| 2021 | $24.53 | $7.16 | 3.43x | $17.37 | $3.1M | 430.5K | 43 |
| 2022 | $40.16 | $11.12 | 3.61x | $29.04 | $4.9M | 438.0K | 41 |
| 2023 | $49.49 | $12.90 | 3.84x | $36.59 | $5.4M | 422.0K | 44 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J9299 | Injection, nivolumab, 1 mg | 153.5K | $3.5M | $22.50 | 3.36x |
| J0897 | Injection, denosumab, 1 mg | 114.5K | $1.9M | $16.63 | 3.52x |
| J9271 | Injection, pembrolizumab, 1 mg | 42.8K | $1.8M | $42.35 | 3.69x |
| J9145 | Injection, daratumumab, 10 mg | 38.6K | $1.8M | $46.66 | 3.81x |
| J9228 | Injection, ipilimumab, 1 mg | 7.4K | $876.1K | $118.14 | 2.78x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 7.2K | $633.0K | $87.38 | 3.01x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 5.8K | $612.1K | $105.16 | 3.94x |
| Q5111 | Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg | 4.2K | $598.7K | $142.96 | 4.00x |
| Q5120 | Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo), 0.5 mg | 1.9K | $411.8K | $219.96 | 4.14x |
| J9173 | Injection, durvalumab, 10 mg | 6.7K | $409.8K | $61.16 | 3.64x |
| J1569 | Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg | 10.9K | $388.3K | $35.71 | 3.84x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 3.0K | $383.4K | $129.18 | 2.79x |
| Q0138 | Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) | 495.2K | $322.6K | $0.65 | 3.58x |
| J2796 | Injection, romiplostim, 10 micrograms | 3.7K | $275.2K | $73.97 | 3.82x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 4.8K | $251.9K | $52.16 | 3.68x |
| Q5106 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units | 35.4K | $240.6K | $6.80 | 4.10x |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | 31.2K | $238.5K | $7.65 | 4.43x |
| 96367 | Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less | 9.6K | $225.9K | $23.41 | 4.00x |
| J2505 | Injection, pegfilgrastim, 6 mg | 68 | $221.5K | $3.3K | 3.10x |
| J9310 | Injection, rituximab, 100 mg | 282 | $184.7K | $654.97 | 3.37x |
This provider submits charges 3.86 times higher than what Medicare actually pays.
A markup ratio of 3.86x means for every $100 Medicare pays, this provider initially charges $386. 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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