⚠️ This provider averages 888 services per working day — physically unusual for an individual practitioner
Based on 2.2M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $36.3M in total Medicare payments ranks in the 99th percentile of Hematology-Oncology providers nationally.
Averaging 888 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 | $24.54 | $16.34 | 1.50x | $8.20 | $2.7M | 162.6K | 5.5K |
| 2015 | $56.31 | $16.34 | 3.45x | $39.97 | $3.8M | 230.9K | 7.8K |
| 2016 | $24.52 | $16.34 | 1.50x | $8.18 | $3.2M | 194.2K | 6.6K |
| 2017 | $27.42 | $16.34 | 1.68x | $11.08 | $4.1M | 252.0K | 8.5K |
| 2018 | $46.59 | $16.34 | 2.85x | $30.25 | $3.5M | 216.6K | 7.3K |
| 2019 | $48.23 | $16.34 | 2.95x | $31.89 | $2.9M | 175.7K | 6.0K |
| 2020 | $46.00 | $16.34 | 2.82x | $29.66 | $3.9M | 237.8K | 8.1K |
| 2021 | $32.14 | $16.34 | 1.97x | $15.80 | $4.1M | 253.6K | 8.6K |
| 2022 | $64.70 | $16.34 | 3.96x | $48.36 | $4.6M | 279.5K | 9.5K |
| 2023 | $44.93 | $16.34 | 2.75x | $28.59 | $3.5M | 216.8K | 7.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 96413 | Chemotherapy administration, IV infusion, first hour | 478.9K | $11.3M | $23.56 | 2.04x |
| 96415 | Chemotherapy IV infusion, each additional hour | 353.9K | $4.6M | $12.92 | 1.91x |
| 99214 | Office/outpatient visit, moderate complexity | 140.0K | $3.7M | $26.60 | 2.02x |
| 96365 | IV infusion for therapy, first hour | 225.9K | $2.6M | $11.39 | 2.76x |
| 36415 | Insertion of needle into vein | 119.5K | $1.4M | $11.93 | 2.36x |
| 96375 | Therapeutic IV push, each additional substance | 77.4K | $1.3M | $16.86 | 2.69x |
| 99215 | Office/outpatient visit, high complexity | 75.2K | $1.1M | $15.12 | 2.98x |
| 85025 | Complete blood cell count | 36.8K | $1.1M | $30.26 | 4.18x |
| J9271 | Injection, pembrolizumab | 58.6K | $993.2K | $16.96 | 1.39x |
| 80053 | Comprehensive metabolic panel | 78.4K | $894.9K | $11.42 | 4.28x |
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 TN for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Ross Kerns, M.D. | Knoxville, TN | $38.6M | ✓ 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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