This provider averages 149 services per working day
Based on 298.9K total services over 8 years (250 working days/year). Learn about impossible service volumes →
This provider's $6.9M in total Medicare payments ranks in the 98th percentile of Hematology-Oncology providers nationally.
Averaging 149 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 7357% from 2016 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 734% in 2022
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 | $131.31 | $70.48 | 1.86x | $60.83 | $39.6K | 562 | 10 |
| 2017 | $146.74 | $78.64 | 1.87x | $68.10 | $206.4K | 2.6K | 14 |
| 2018 | $161.47 | $88.08 | 1.83x | $73.39 | $261.6K | 3.0K | 13 |
| 2019 | $162.48 | $78.14 | 2.08x | $84.34 | $257.9K | 3.3K | 12 |
| 2020 | $198.78 | $85.58 | 2.32x | $113.20 | $274.5K | 3.2K | 15 |
| 2021 | $67.30 | $19.84 | 3.39x | $47.46 | $310.2K | 15.6K | 17 |
| 2022 | $83.71 | $22.65 | 3.70x | $61.06 | $2.6M | 114.3K | 30 |
| 2023 | $73.31 | $18.89 | 3.88x | $54.42 | $3.0M | 156.3K | 34 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 54.6K | $2.3M | $42.39 | 3.84x |
| J9022 | Injection, atezolizumab, 10 mg | 17.0K | $1.1M | $63.95 | 3.83x |
| J0897 | Injection, denosumab, 1 mg | 54.7K | $943.9K | $17.27 | 3.44x |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 3.1K | $502.7K | $162.15 | 2.59x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 5.3K | $452.2K | $84.94 | 3.35x |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 6.2K | $370.2K | $59.32 | 2.48x |
| Q5122 | Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg | 1.1K | $172.1K | $154.23 | 3.86x |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 1.9K | $161.7K | $84.37 | 2.78x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 1.0K | $160.4K | $155.69 | 3.05x |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 1.2K | $147.9K | $118.67 | 3.14x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 1.0K | $107.8K | $107.39 | 4.13x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1.9K | $94.9K | $48.72 | 3.10x |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 616 | $69.0K | $111.97 | 2.13x |
| Q5108 | Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg | 588 | $57.4K | $97.57 | 3.87x |
| Q0138 | Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) | 89.8K | $54.0K | $0.60 | 4.83x |
| J1439 | Injection, ferric carboxymaltose, 1 mg | 26.3K | $23.1K | $0.88 | 4.54x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 2.5K | $19.1K | $7.75 | 2.97x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 155 | $18.0K | $116.10 | 2.12x |
| 38222 | Biopsy and aspiration of bone marrow sample for diagnosis | 155 | $15.9K | $102.48 | 3.94x |
| 96372 | Injection of drug or substance under skin or into muscle | 1.3K | $14.9K | $11.42 | 3.68x |
This provider submits charges 3.51 times higher than what Medicare actually pays.
A markup ratio of 3.51x means for every $100 Medicare pays, this provider initially charges $351. 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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