⚠️ This provider averages 1.8K services per working day — physically unusual for an individual practitioner
Based on 4.4M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $34.3M in total Medicare payments ranks in the 99th percentile of Hematology-Oncology providers nationally.
Averaging 1.8K services per working day raises questions about billing patterns.
AI-generated analysis based on Medicare payment data.
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 | $22.23 | $7.81 | 2.85x | $14.42 | $3.2M | 414.6K | 3.1K |
| 2015 | $29.73 | $7.81 | 3.81x | $21.92 | $2.6M | 336.8K | 2.5K |
| 2016 | $18.80 | $7.81 | 2.41x | $10.99 | $2.9M | 368.9K | 2.8K |
| 2017 | $18.95 | $7.81 | 2.43x | $11.14 | $4.1M | 522.0K | 3.9K |
| 2018 | $14.12 | $7.81 | 1.81x | $6.31 | $4.2M | 541.9K | 4.0K |
| 2019 | $28.33 | $7.81 | 3.63x | $20.52 | $4.5M | 579.1K | 4.3K |
| 2020 | $21.47 | $7.81 | 2.75x | $13.66 | $2.7M | 345.4K | 2.6K |
| 2021 | $15.25 | $7.81 | 1.95x | $7.44 | $3.4M | 437.2K | 3.3K |
| 2022 | $29.04 | $7.81 | 3.72x | $21.23 | $3.2M | 414.0K | 3.1K |
| 2023 | $25.97 | $7.81 | 3.33x | $18.16 | $3.4M | 433.8K | 3.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 96413 | Chemotherapy administration, IV infusion, first hour | 2.1M | $11.1M | $5.36 | 1.80x |
| 99214 | Office/outpatient visit, moderate complexity | 338.1K | $4.1M | $12.16 | 2.27x |
| 96415 | Chemotherapy IV infusion, each additional hour | 175.2K | $2.3M | $12.89 | 2.11x |
| 36415 | Insertion of needle into vein | 353.2K | $2.0M | $5.65 | 2.55x |
| 96375 | Therapeutic IV push, each additional substance | 180.1K | $1.7M | $9.71 | 2.58x |
| 85025 | Complete blood cell count | 251.3K | $1.7M | $6.60 | 3.98x |
| J9271 | Injection, pembrolizumab | 185.9K | $1.4M | $7.31 | 1.35x |
| 99215 | Office/outpatient visit, high complexity | 224.7K | $1.3M | $5.63 | 2.78x |
| 96365 | IV infusion for therapy, first hour | 84.6K | $1.2M | $14.18 | 2.70x |
| 80053 | Comprehensive metabolic panel | 105.2K | $721.8K | $6.86 | 4.22x |
This provider submits charges 2 times higher than what Medicare actually pays.
A markup ratio of 2x means for every $100 Medicare pays, this provider initially charges $200. This is lower 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 TX for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Benjamin Downie, MD | Georgetown, TX | $36.6M | ✓ 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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