⚠️ This provider averages 1.3K services per working day — physically unusual for an individual practitioner
Based on 2.2M total services over 7 years (250 working days/year). Learn about impossible service volumes →
This provider's $24.4M in total Medicare payments ranks in the 99th percentile of Hematology-Oncology providers nationally.
Averaging 1.3K services per working day raises questions about billing patterns.
Medicare payments to this provider grew 546% from 2017 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 518% in 2018
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 |
|---|---|---|---|---|---|---|---|
| 2017 | $44.61 | $8.36 | 5.34x | $36.25 | $536.8K | 64.2K | 34 |
| 2018 | $43.12 | $8.77 | 4.92x | $34.35 | $3.3M | 378.0K | 51 |
| 2019 | $56.95 | $13.12 | 4.34x | $43.83 | $5.7M | 432.1K | 61 |
| 2020 | $46.27 | $10.65 | 4.34x | $35.62 | $5.1M | 474.5K | 58 |
| 2021 | $44.23 | $10.07 | 4.39x | $34.16 | $3.3M | 330.5K | 61 |
| 2022 | $54.02 | $11.43 | 4.73x | $42.59 | $3.0M | 266.3K | 55 |
| 2023 | $63.74 | $14.34 | 4.44x | $49.40 | $3.5M | 241.7K | 62 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 172.0K | $7.0M | $40.59 | 3.91x |
| J9299 | Injection, nivolumab, 1 mg | 140.3K | $3.1M | $22.32 | 3.96x |
| J0897 | Injection, denosumab, 1 mg | 145.2K | $2.2M | $15.37 | 3.43x |
| J2505 | Injection, pegfilgrastim, 6 mg | 507 | $1.5M | $3.0K | 3.16x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 15.1K | $1.2M | $80.40 | 4.64x |
| G9678 | Oncology care model (ocm) monthly enhanced oncology services (meos) payment for ocm enhanced services. g9678 payments may only be made to ocm practitioners for ocm beneficiaries for the furnishment of enhanced services as defined in the ocm participation a | 6.1K | $969.3K | $158.51 | 1.69x |
| J9312 | Injection, rituximab, 10 mg | 10.7K | $794.0K | $74.56 | 2.25x |
| J9035 | Injection, bevacizumab, 10 mg | 11.0K | $677.8K | $61.47 | 3.27x |
| J1439 | Injection, ferric carboxymaltose, 1 mg | 671.3K | $586.5K | $0.87 | 4.36x |
| J9173 | Injection, durvalumab, 10 mg | 10.1K | $569.2K | $56.19 | 3.90x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 5.7K | $544.8K | $94.76 | 6.82x |
| J9310 | Injection, rituximab, 100 mg | 643 | $451.7K | $702.56 | 2.39x |
| J9305 | Injection, pemetrexed, 10 mg | 6.1K | $326.6K | $53.72 | 2.79x |
| Q5107 | Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg | 13.0K | $317.3K | $24.37 | 5.13x |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | 104.7K | $288.8K | $2.76 | 5.04x |
| J1454 | Injection, fosnetupitant 235 mg and palonosetron 0.25 mg | 545 | $193.8K | $355.67 | 5.51x |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 1.2K | $191.1K | $157.80 | 10.21x |
| Q0138 | Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) | 250.9K | $190.2K | $0.76 | 3.56x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 23.3K | $190.0K | $8.16 | 8.51x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 1.2K | $170.9K | $147.12 | 4.62x |
This provider submits charges 4.51 times higher than what Medicare actually pays.
A markup ratio of 4.51x means for every $100 Medicare pays, this provider initially charges $451. 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 TN for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Ross Kerns, M.D. | Knoxville, TN | $38.6M | ✓ Clear |
| Bradley Somer, MD | Germantown, TN | $36.3M | ✓ Clear |
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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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