Statistical flag only — not an accusation of fraud
⚠️ This provider averages 534 services per working day — physically unusual for an individual practitioner
Based on 1.3M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $12.1M in total Medicare payments ranks in the 99th percentile of Hematology-Oncology providers nationally.
Averaging 534 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 234% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 74/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 721% 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 | $28.21 | $7.54 | 3.74x | $20.67 | $1.2M | 159.7K | 52 |
| 2015 | $30.29 | $8.04 | 3.77x | $22.25 | $1.2M | 143.6K | 59 |
| 2016 | $27.54 | $7.62 | 3.61x | $19.92 | $1.1M | 139.2K | 63 |
| 2017 | $39.86 | $11.76 | 3.39x | $28.10 | $1.0M | 85.2K | 57 |
| 2018 | $26.31 | $7.79 | 3.38x | $18.52 | $930.2K | 119.4K | 56 |
| 2019 | $32.56 | $9.23 | 3.53x | $23.33 | $1.0M | 113.3K | 56 |
| 2020 | $39.18 | $8.87 | 4.42x | $30.31 | $260.6K | 29.4K | 33 |
| 2021 | $525.48 | $125.90 | 4.17x | $399.58 | $152.5K | 1.2K | 7 |
| 2022 | $43.72 | $7.73 | 5.66x | $35.99 | $1.3M | 161.9K | 48 |
| 2023 | $55.13 | $10.52 | 5.24x | $44.61 | $4.0M | 383.0K | 60 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 70.8K | $3.0M | $42.45 | 3.42x |
| J2505 | Injection, pegfilgrastim, 6 mg | 393 | $1.2M | $2.9K | 2.28x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 12.3K | $1.1M | $88.65 | 4.11x |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | 251.9K | $703.2K | $2.79 | 4.96x |
| 78815 | Nuclear medicine study with ct imaging skull base to mid-thigh | 461 | $520.2K | $1.1K | 3.99x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 4.6K | $508.8K | $110.00 | 6.01x |
| J0897 | Injection, denosumab, 1 mg | 27.7K | $476.3K | $17.18 | 3.54x |
| J9299 | Injection, nivolumab, 1 mg | 16.1K | $380.2K | $23.64 | 3.45x |
| J2469 | Injection, palonosetron hcl, 25 mcg | 19.3K | $220.7K | $11.42 | 6.56x |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 2.0K | $172.9K | $87.61 | 4.11x |
| 96367 | Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less | 6.4K | $162.2K | $25.46 | 4.81x |
| Q5101 | Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram | 293.5K | $145.0K | $0.49 | 6.49x |
| 99223 | Initial hospital inpatient care per day, typically 70 minutes | 809 | $137.4K | $169.87 | 3.77x |
| 80053 | Blood test, comprehensive group of blood chemicals | 12.1K | $133.0K | $10.96 | 4.05x |
| 83970 | Parathormone (parathyroid hormone) level | 2.5K | $132.0K | $51.94 | 4.33x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 13.4K | $131.4K | $9.77 | 3.08x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 2.4K | $131.2K | $55.21 | 3.98x |
| J2506 | Injection, pegfilgrastim, excludes biosimilar, 0.5 mg | 1.4K | $129.3K | $90.57 | 15.94x |
| 96401 | Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle | 2.0K | $126.7K | $62.11 | 3.80x |
| J1442 | Injection, filgrastim (g-csf), 1 microgram | 159.2K | $124.3K | $0.78 | 5.77x |
This provider submits charges 4.38 times higher than what Medicare actually pays.
A markup ratio of 4.38x means for every $100 Medicare pays, this provider initially charges $438. 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