⚠️ This provider averages 1.4K services per working day — physically unusual for an individual practitioner
Based on 3.4M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $34.4M in total Medicare payments ranks in the 99th percentile of Hematology-Oncology providers nationally.
Averaging 1.4K services per working day raises questions about billing patterns.
Medicare payments to this provider grew 81% from 2014 to 2023.
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 | $16.42 | $8.20 | 2.00x | $8.22 | $2.2M | 268.8K | 44 |
| 2015 | $13.75 | $7.99 | 1.72x | $5.76 | $1.9M | 233.7K | 38 |
| 2016 | $14.57 | $8.75 | 1.67x | $5.82 | $2.5M | 283.8K | 41 |
| 2017 | $16.23 | $8.84 | 1.84x | $7.39 | $3.5M | 397.3K | 43 |
| 2018 | $21.59 | $10.82 | 2.00x | $10.77 | $3.6M | 332.3K | 42 |
| 2019 | $19.60 | $9.74 | 2.01x | $9.86 | $3.6M | 368.9K | 44 |
| 2020 | $23.58 | $10.67 | 2.21x | $12.91 | $3.9M | 369.6K | 45 |
| 2021 | $37.58 | $11.90 | 3.16x | $25.68 | $4.7M | 390.9K | 47 |
| 2022 | $34.77 | $10.67 | 3.26x | $24.10 | $4.5M | 424.9K | 49 |
| 2023 | $39.83 | $10.83 | 3.68x | $29.00 | $4.0M | 368.2K | 47 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 127.8K | $5.2M | $40.33 | 3.01x |
| J0897 | Injection, denosumab, 1 mg | 291.5K | $4.3M | $14.87 | 2.24x |
| J9299 | Injection, nivolumab, 1 mg | 140.8K | $3.2M | $22.72 | 2.91x |
| J9310 | Injection, rituximab, 100 mg | 4.5K | $2.8M | $615.71 | 1.32x |
| J1569 | Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg | 72.1K | $2.3M | $32.41 | 2.21x |
| J9312 | Injection, rituximab, 10 mg | 27.7K | $2.0M | $72.20 | 2.25x |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | 177.6K | $1.5M | $8.47 | 2.48x |
| J9035 | Injection, bevacizumab, 10 mg | 21.8K | $1.2M | $56.62 | 1.45x |
| J1568 | Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg | 32.0K | $1.1M | $32.88 | 2.89x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 11.0K | $997.9K | $90.95 | 2.43x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 7.8K | $906.9K | $116.48 | 2.41x |
| J1439 | Injection, ferric carboxymaltose, 1 mg | 1.0M | $867.0K | $0.85 | 2.35x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 11.6K | $684.2K | $58.77 | 2.15x |
| Q5118 | Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg | 18.7K | $614.5K | $32.83 | 4.37x |
| J9395 | Injection, fulvestrant, 25 mg | 14.8K | $612.4K | $41.24 | 3.01x |
| J9041 | Injection, bortezomib (velcade), 0.1 mg | 14.3K | $501.5K | $35.15 | 2.40x |
| J9055 | Injection, cetuximab, 10 mg | 9.8K | $437.7K | $44.80 | 1.67x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 6.5K | $375.8K | $57.82 | 2.35x |
| J2505 | Injection, pegfilgrastim, 6 mg | 100 | $340.2K | $3.4K | 1.45x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 1.7K | $275.4K | $164.24 | 2.10x |
This provider submits charges 2.49 times higher than what Medicare actually pays.
A markup ratio of 2.49x means for every $100 Medicare pays, this provider initially charges $249. 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 CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Luke Dreisbach, M.D. | Rancho Mirage, CA | $77.2M | ✓ Clear |
| Sachin Gupta, M.D. | Fresno, CA | $55.1M | ✓ Clear |
| Ravi Rao, MD | Fresno, CA | $49.1M | ⚠️ Flagged |
| Michael Sherman, M.D., PHD | Walnut Creek, CA | $38.9M | ✓ Clear |
| Nerses Tchekmedyian, M.D. | Irvine, CA | $38.0M | ✓ 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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