This provider's $5.7M in total Medicare payments ranks in the 99th percentile of Hematology providers nationally.
Medicare payments to this provider grew 111% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 57% 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 | $272.28 | $42.90 | 6.35x | $229.38 | $339.9K | 12.9K | 2.9K |
| 2015 | $733.77 | $174.46 | 4.21x | $559.31 | $533.4K | 17.5K | 4.4K |
| 2016 | $417.23 | $91.95 | 4.54x | $325.28 | $689.0K | 19.1K | 5.3K |
| 2017 | $469.20 | $118.21 | 3.97x | $350.99 | $587.1K | 19.9K | 4.8K |
| 2018 | $502.41 | $129.83 | 3.87x | $372.58 | $641.6K | 7.9K | 3.6K |
| 2019 | $318.61 | $52.06 | 6.12x | $266.55 | $518.8K | 5.3K | 1.9K |
| 2020 | $268.85 | $59.18 | 4.54x | $209.67 | $441.4K | 4.3K | 1.5K |
| 2021 | $239.70 | $56.81 | 4.22x | $182.89 | $594.9K | 5.0K | 1.9K |
| 2022 | $262.39 | $52.62 | 4.99x | $209.77 | $650.4K | 5.8K | 2.3K |
| 2023 | $275.08 | $43.98 | 6.25x | $231.10 | $717.7K | 7.0K | 3.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 22.4K | $2.8M | $125.60 | 3.45x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 10.2K | $978.0K | $95.99 | 3.36x |
| J2505 | Injection, pegfilgrastim, 6 mg | 99 | $322.4K | $3.3K | 2.64x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 1.5K | $256.3K | $175.33 | 3.86x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 3.2K | $195.6K | $61.60 | 3.52x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.8K | $162.7K | $88.88 | 3.49x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 1.1K | $124.5K | $113.79 | 8.26x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 10.1K | $104.9K | $10.35 | 5.41x |
| 80053 | Blood test, comprehensive group of blood chemicals | 10.1K | $75.2K | $7.46 | 10.18x |
| 99443 | Physician telephone patient service, 21-30 minutes of medical discussion | 663 | $68.8K | $103.76 | 2.41x |
| J9999 | Not otherwise classified, antineoplastic drugs | 14 | $65.0K | $4.6K | 4.07x |
| G9678 | Oncology Care Model service | 366 | $57.4K | $156.80 | 1.02x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 840 | $53.7K | $63.93 | 3.44x |
| 83615 | Lactate dehydrogenase (enzyme) level | 10.1K | $43.4K | $4.28 | 10.27x |
| J9310 | Injection, rituximab, 100 mg | 56 | $36.6K | $654.09 | 3.93x |
| 83735 | Magnesium level | 3.8K | $33.7K | $8.92 | 5.49x |
| 84550 | Uric acid level, blood | 9.7K | $30.8K | $3.18 | 10.39x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 454 | $28.8K | $63.50 | 5.13x |
| 36415 | Insertion of needle into vein for collection of blood sample | 9.2K | $27.7K | $3.00 | 6.67x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 465 | $26.4K | $56.79 | 7.22x |
This provider submits charges 3.91 times higher than what Medicare actually pays.
A markup ratio of 3.91x means for every $100 Medicare pays, this provider initially charges $391. 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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