Statistical flag only — not an accusation of fraud
⚠️ This provider averages 1.3K services per working day — physically unusual for an individual practitioner
Based on 3.3M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $19.3M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Averaging 1.3K services per working day raises questions about billing patterns.
Medicare payments to this provider grew 411% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 77/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 79% 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 |
|---|---|---|---|---|---|---|---|
| 2014 | $22.82 | $5.16 | 4.42x | $17.66 | $704.3K | 136.4K | 32 |
| 2015 | $25.93 | $5.89 | 4.40x | $20.04 | $978.5K | 166.1K | 31 |
| 2016 | $26.89 | $5.69 | 4.73x | $21.20 | $1.1M | 197.5K | 29 |
| 2017 | $30.48 | $5.57 | 5.47x | $24.91 | $1.9M | 336.3K | 34 |
| 2018 | $30.27 | $6.29 | 4.81x | $23.98 | $2.3M | 361.3K | 46 |
| 2019 | $23.46 | $4.59 | 5.11x | $18.87 | $1.8M | 385.8K | 48 |
| 2020 | $27.83 | $5.62 | 4.95x | $22.21 | $2.1M | 366.1K | 44 |
| 2021 | $27.93 | $5.03 | 5.55x | $22.90 | $1.8M | 353.2K | 47 |
| 2022 | $31.58 | $6.32 | 5.00x | $25.26 | $3.2M | 502.6K | 51 |
| 2023 | $38.16 | $7.79 | 4.90x | $30.37 | $3.6M | 462.2K | 56 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | 1.1M | $3.2M | $2.86 | 7.16x |
| J2505 | Injection, pegfilgrastim, 6 mg | 850 | $2.6M | $3.1K | 5.06x |
| J0897 | Injection, denosumab, 1 mg | 144.7K | $2.2M | $15.34 | 3.25x |
| J9299 | Injection, nivolumab, 1 mg | 71.2K | $1.7M | $23.45 | 3.02x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 18.0K | $1.2M | $66.69 | 2.28x |
| J9271 | Injection, pembrolizumab, 1 mg | 29.1K | $1.2M | $40.97 | 3.08x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 5.6K | $723.8K | $129.48 | 5.30x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 6.9K | $683.9K | $99.76 | 2.30x |
| J9035 | Injection, bevacizumab, 10 mg | 9.4K | $582.7K | $61.72 | 3.40x |
| J9144 | Injection, daratumumab, 10 mg and hyaluronidase-fihj | 12.1K | $450.2K | $37.33 | 3.65x |
| J1439 | Injection, ferric carboxymaltose, 1 mg | 424.5K | $374.9K | $0.88 | 4.52x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 4.8K | $308.1K | $64.13 | 4.74x |
| J9041 | Injection, bortezomib, 0.1 mg | 11.1K | $286.5K | $25.89 | 4.79x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 30.2K | $263.5K | $8.73 | 4.01x |
| J2506 | Injection, pegfilgrastim, excludes biosimilar, 0.5 mg | 2.0K | $214.9K | $109.86 | 13.14x |
| Q5107 | Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg | 5.1K | $206.9K | $40.57 | 4.54x |
| J2469 | Injection, palonosetron hcl, 25 mcg | 22.0K | $183.2K | $8.32 | 14.48x |
| 80053 | Blood test, comprehensive group of blood chemicals | 16.6K | $181.3K | $10.90 | 5.69x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 2.9K | $181.2K | $62.76 | 2.50x |
| 96401 | Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle | 2.2K | $158.4K | $71.66 | 2.86x |
This provider submits charges 4.99 times higher than what Medicare actually pays.
A markup ratio of 4.99x means for every $100 Medicare pays, this provider initially charges $499. 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.
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data