Statistical flag only — not an accusation of fraud
⚠️ This provider averages 1.6K services per working day — physically unusual for an individual practitioner
Based on 3.9M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $48.1M in total Medicare payments ranks in the 99th percentile of Hematology-Oncology providers nationally.
Averaging 1.6K services per working day raises questions about billing patterns.
Medicare payments to this provider grew 188% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 66/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 69% in 2016
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 | $36.96 | $10.56 | 3.50x | $26.40 | $2.1M | 197.1K | 73 |
| 2015 | $37.56 | $11.02 | 3.41x | $26.54 | $2.6M | 233.6K | 79 |
| 2016 | $38.25 | $11.00 | 3.48x | $27.25 | $4.3M | 394.6K | 73 |
| 2017 | $37.83 | $11.32 | 3.34x | $26.51 | $5.0M | 442.9K | 79 |
| 2018 | $45.47 | $13.99 | 3.25x | $31.48 | $4.9M | 351.8K | 72 |
| 2019 | $37.29 | $12.11 | 3.08x | $25.18 | $6.8M | 559.1K | 82 |
| 2020 | $41.81 | $13.07 | 3.20x | $28.74 | $6.8M | 518.2K | 81 |
| 2021 | $38.18 | $10.85 | 3.52x | $27.33 | $4.9M | 448.4K | 76 |
| 2022 | $44.15 | $12.85 | 3.44x | $31.30 | $4.8M | 374.4K | 64 |
| 2023 | $54.55 | $16.13 | 3.38x | $38.42 | $6.0M | 371.8K | 46 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 303.5K | $12.4M | $40.96 | 3.09x |
| J9299 | Injection, nivolumab, 1 mg | 213.9K | $4.7M | $22.14 | 3.10x |
| J2505 | Injection, pegfilgrastim, 6 mg | 739 | $2.3M | $3.1K | 2.82x |
| J0897 | Injection, denosumab, 1 mg | 119.6K | $1.8M | $14.92 | 2.78x |
| J9310 | Injection, rituximab, 100 mg | 2.6K | $1.6M | $621.72 | 2.44x |
| J1569 | Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg | 45.4K | $1.5M | $33.51 | 3.02x |
| J9264 | Injection, paclitaxel protein-bound particles, 1 mg | 154.6K | $1.4M | $9.28 | 2.74x |
| 78815 | Nuclear medicine study with ct imaging skull base to mid-thigh | 1.3K | $1.3M | $1.1K | 3.95x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 14.7K | $1.3M | $91.18 | 3.13x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 11.9K | $1.3M | $112.26 | 3.57x |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | 151.7K | $1.3M | $8.67 | 2.74x |
| J9041 | Injection, bortezomib, 0.1 mg | 38.5K | $1.3M | $33.06 | 2.94x |
| J9305 | Injection, pemetrexed, not otherwise specified, 10 mg | 23.8K | $1.2M | $52.33 | 2.37x |
| J9144 | Injection, daratumumab, 10 mg and hyaluronidase-fihj | 32.4K | $1.2M | $37.08 | 2.97x |
| J2796 | Injection, romiplostim, 10 micrograms | 20.0K | $1.0M | $52.10 | 2.09x |
| J9035 | Injection, bevacizumab, 10 mg | 13.2K | $753.1K | $56.87 | 2.68x |
| J9312 | Injection, rituximab, 10 mg | 10.0K | $729.5K | $72.76 | 3.28x |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 1.5K | $543.5K | $371.77 | 1.72x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 7.4K | $446.9K | $60.60 | 3.20x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 41.6K | $368.9K | $8.87 | 3.27x |
This provider submits charges 3.33 times higher than what Medicare actually pays.
A markup ratio of 3.33x means for every $100 Medicare pays, this provider initially charges $333. 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 FL for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Christopher Lobo, MD | Port Charlotte, FL | $60.5M | ⚠️ Flagged |
| Maen Hussein, M.D. | Tavares, FL | $57.6M | ✓ Clear |
| Vikas Malhotra, M.D. | Spring Hill, FL | $52.8M | ✓ Clear |
| Andrew Lipman, M.D. | Naples, FL | $51.1M | ⚠️ Flagged |
| Rebecca Kosloff, MD | Bonita Springs, FL | $47.1M | ✓ 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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