This provider averages 129 services per working day
Based on 321.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $8.0M in total Medicare payments ranks in the 98th percentile of Hematology-Oncology providers nationally.
Averaging 129 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 | $325.97 | $74.39 | 4.38x | $251.58 | $779.7K | 30.0K | 11.5K |
| 2015 | $322.32 | $69.71 | 4.62x | $252.61 | $825.5K | 33.7K | 12.3K |
| 2016 | $319.23 | $71.41 | 4.47x | $247.82 | $853.1K | 32.6K | 12.6K |
| 2017 | $352.40 | $77.13 | 4.57x | $275.27 | $883.1K | 30.5K | 12.5K |
| 2018 | $370.91 | $81.64 | 4.54x | $289.27 | $980.9K | 35.6K | 15.0K |
| 2019 | $344.90 | $80.49 | 4.29x | $264.41 | $993.9K | 38.1K | 15.2K |
| 2020 | $331.23 | $65.14 | 5.08x | $266.09 | $991.8K | 36.4K | 14.8K |
| 2021 | $339.38 | $58.09 | 5.84x | $281.29 | $729.5K | 32.0K | 14.1K |
| 2022 | $176.55 | $33.64 | 5.25x | $142.91 | $550.9K | 29.1K | 13.6K |
| 2023 | $143.50 | $26.49 | 5.42x | $117.01 | $429.9K | 23.7K | 11.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2505 | Injection, pegfilgrastim, 6 mg | 473 | $1.4M | $3.1K | 4.97x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 8.3K | $688.7K | $82.75 | 2.93x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 9.0K | $484.2K | $53.89 | 3.06x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 4.0K | $430.9K | $107.21 | 6.55x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 3.8K | $424.7K | $112.38 | 2.88x |
| G9678 | Oncology Care Model service | 2.4K | $375.6K | $157.74 | 1.01x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 37.8K | $340.0K | $8.99 | 3.89x |
| 80053 | Blood test, comprehensive group of blood chemicals | 29.9K | $308.7K | $10.31 | 6.01x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 1.8K | $278.3K | $152.99 | 3.11x |
| 82728 | Ferritin (blood protein) level | 15.6K | $242.3K | $15.54 | 3.73x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 4.1K | $212.3K | $52.20 | 5.82x |
| J9310 | Injection, rituximab, 100 mg | 308 | $185.0K | $600.56 | 3.38x |
| 83550 | Iron binding capacity | 14.8K | $146.3K | $9.91 | 3.43x |
| J3490 | Unclassified drugs | 708 | $142.6K | $201.42 | 1.91x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 2.4K | $140.7K | $58.66 | 3.61x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 2.2K | $133.2K | $60.90 | 2.75x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 8.8K | $132.7K | $15.10 | 6.16x |
| 83540 | Iron level | 15.0K | $110.6K | $7.36 | 3.53x |
| 83615 | Lactate dehydrogenase (enzyme) level | 20.4K | $104.1K | $5.11 | 5.87x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.2K | $99.0K | $82.29 | 3.02x |
This provider submits charges 4.39 times higher than what Medicare actually pays.
A markup ratio of 4.39x means for every $100 Medicare pays, this provider initially charges $439. 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 VA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Thomas Alberico, MD | Norfolk, VA | $38.5M | ⚠️ Flagged |
| Mark Fleming, MD | Hampton, VA | $37.6M | ⚠️ Flagged |
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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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