Statistical flag only — not an accusation of fraud
⚠️ This provider averages 926 services per working day — physically unusual for an individual practitioner
Based on 2.3M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $26.4M in total Medicare payments ranks in the 99th percentile of Medical Oncology providers nationally.
Averaging 926 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 103% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 68/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 74% in 2018
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 | $50.56 | $13.19 | 3.83x | $37.37 | $1.8M | 140.2K | 61 |
| 2015 | $42.43 | $10.43 | 4.07x | $32.00 | $1.9M | 183.7K | 61 |
| 2016 | $33.24 | $8.13 | 4.09x | $25.11 | $2.5M | 306.7K | 57 |
| 2017 | $40.94 | $9.41 | 4.35x | $31.53 | $1.8M | 193.2K | 60 |
| 2018 | $51.83 | $14.68 | 3.53x | $37.15 | $3.2M | 215.6K | 62 |
| 2019 | $41.39 | $12.11 | 3.42x | $29.28 | $2.9M | 237.2K | 58 |
| 2020 | $42.25 | $12.48 | 3.39x | $29.77 | $3.3M | 260.7K | 59 |
| 2021 | $35.84 | $9.79 | 3.66x | $26.05 | $2.4M | 242.1K | 56 |
| 2022 | $37.90 | $10.68 | 3.55x | $27.22 | $2.9M | 269.7K | 61 |
| 2023 | $44.10 | $14.05 | 3.14x | $30.05 | $3.8M | 267.0K | 53 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2505 | Injection, pegfilgrastim, 6 mg | 1.5K | $4.6M | $3.1K | 2.39x |
| J9271 | Injection, pembrolizumab, 1 mg | 99.8K | $4.1M | $40.71 | 2.28x |
| J0897 | Injection, denosumab, 1 mg | 219.4K | $3.1M | $13.95 | 2.96x |
| J9299 | Injection, nivolumab, 1 mg | 112.0K | $2.4M | $21.77 | 2.68x |
| J9041 | Injection, bortezomib, 0.1 mg | 35.4K | $1.2M | $32.71 | 2.39x |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 5.7K | $909.4K | $159.63 | 9.77x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 16.5K | $826.6K | $50.24 | 1.88x |
| J9310 | Injection, rituximab, 100 mg | 1.2K | $757.0K | $610.98 | 2.43x |
| J9144 | Injection, daratumumab, 10 mg and hyaluronidase-fihj | 16.4K | $620.4K | $37.88 | 2.11x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 7.2K | $599.8K | $83.43 | 1.56x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 5.6K | $551.1K | $98.14 | 3.57x |
| J1439 | Injection, ferric carboxymaltose, 1 mg | 480.8K | $410.2K | $0.85 | 3.11x |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | 133.2K | $403.6K | $3.03 | 4.11x |
| 78815 | Nuclear medicine study from skull base to mid-thigh with ct scan | 485 | $332.3K | $685.14 | 4.71x |
| 74177 | Ct scan of abdomen and pelvis with contrast | 2.0K | $320.3K | $162.12 | 12.00x |
| J1627 | Injection, granisetron, extended-release, 0.1 mg | 85.3K | $317.3K | $3.72 | 3.23x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 30.4K | $267.1K | $8.79 | 3.98x |
| J9035 | Injection, bevacizumab, 10 mg | 4.7K | $241.9K | $51.69 | 2.66x |
| 80048 | Blood test, basic group of blood chemicals (calcium, total) | 28.4K | $234.6K | $8.26 | 6.90x |
| J2506 | Injection, pegfilgrastim, excludes biosimilar, 0.5 mg | 1.9K | $226.1K | $120.75 | 5.09x |
This provider submits charges 3.63 times higher than what Medicare actually pays.
A markup ratio of 3.63x means for every $100 Medicare pays, this provider initially charges $363. 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.
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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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