This provider's $5.7M in total Medicare payments ranks in the 97th percentile of Hematology-Oncology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $214.16 | $71.33 | 3.00x | $142.83 | $419.1K | 10.8K | 4.5K |
| 2015 | $307.90 | $102.17 | 3.01x | $205.73 | $346.9K | 6.8K | 2.6K |
| 2016 | $297.43 | $99.05 | 3.00x | $198.38 | $503.6K | 8.1K | 3.2K |
| 2017 | $261.30 | $88.99 | 2.94x | $172.31 | $570.0K | 10.1K | 3.7K |
| 2018 | $439.77 | $159.86 | 2.75x | $279.91 | $753.0K | 10.2K | 3.7K |
| 2019 | $272.06 | $85.80 | 3.17x | $186.26 | $546.3K | 10.1K | 4.0K |
| 2020 | $276.31 | $86.30 | 3.20x | $190.01 | $735.4K | 13.0K | 4.7K |
| 2021 | $223.77 | $66.66 | 3.36x | $157.11 | $692.6K | 15.5K | 5.4K |
| 2022 | $238.59 | $73.12 | 3.26x | $165.47 | $564.6K | 11.3K | 4.4K |
| 2023 | $276.08 | $90.60 | 3.05x | $185.48 | $602.5K | 9.0K | 3.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 78815 | Nuclear medicine study with CT imaging skull base to mid-thigh | 1.1K | $1.2M | $1.0K | 2.29x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.9K | $501.9K | $84.79 | 1.91x |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 1.3K | $489.1K | $386.96 | 2.58x |
| G9678 | Oncology Care Model service | 2.7K | $426.2K | $157.66 | 1.01x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 4.0K | $417.8K | $105.05 | 3.38x |
| 74177 | CT scan of abdomen and pelvis with contrast | 1.8K | $388.9K | $210.92 | 3.05x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.0K | $343.5K | $57.65 | 1.80x |
| 78816 | Nuclear medicine study with CT imaging whole body | 219 | $222.4K | $1.0K | 2.44x |
| 71260 | CT scan chest with contrast | 2.2K | $202.9K | $90.33 | 7.09x |
| J2505 | Injection, pegfilgrastim, 6 mg | 49 | $176.5K | $3.6K | 2.32x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 2.6K | $150.6K | $57.49 | 2.00x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 16.2K | $142.8K | $8.81 | 4.65x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 777 | $84.2K | $108.32 | 2.08x |
| 70553 | MRI scan of brain before and after contrast | 406 | $74.7K | $183.92 | 4.23x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 1.4K | $71.3K | $52.71 | 3.04x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 2.8K | $66.8K | $23.59 | 3.82x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 4.5K | $64.6K | $14.22 | 2.95x |
| 36415 | Insertion of needle into vein for collection of blood sample | 17.0K | $58.7K | $3.46 | 5.21x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 1.1K | $57.7K | $50.59 | 3.46x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 394 | $49.8K | $126.32 | 2.10x |
This provider submits charges 2.83 times higher than what Medicare actually pays.
A markup ratio of 2.83x means for every $100 Medicare pays, this provider initially charges $283. This is higher than the national average.
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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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