Statistical flag only — not an accusation of fraud
⚠️ This provider averages 1.2K services per working day — physically unusual for an individual practitioner
Based on 3.0M total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $29.1M in total Medicare payments ranks in the 99th percentile of Hematology-Oncology providers nationally.
Averaging 1.2K services per working day raises questions about billing patterns.
Medicare payments to this provider grew 822% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 69/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 75% in 2017
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 | $26.33 | $8.67 | 3.04x | $17.66 | $490.3K | 56.6K | 47 |
| 2015 | $39.43 | $7.38 | 5.34x | $32.05 | $792.5K | 107.4K | 45 |
| 2016 | $27.35 | $5.63 | 4.86x | $21.72 | $1.2M | 207.0K | 52 |
| 2017 | $34.96 | $7.87 | 4.44x | $27.09 | $2.0M | 260.0K | 45 |
| 2018 | $40.00 | $9.83 | 4.07x | $30.17 | $3.5M | 354.3K | 53 |
| 2019 | $36.94 | $8.74 | 4.23x | $28.20 | $3.8M | 437.0K | 53 |
| 2020 | $45.21 | $10.03 | 4.51x | $35.18 | $4.7M | 463.7K | 50 |
| 2021 | $46.68 | $11.15 | 4.19x | $35.53 | $4.4M | 395.8K | 55 |
| 2022 | $44.80 | $10.13 | 4.42x | $34.67 | $3.8M | 370.5K | 43 |
| 2023 | $50.92 | $11.39 | 4.47x | $39.53 | $4.5M | 396.8K | 46 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J9299 | Injection, nivolumab, 1 mg | 364.4K | $8.1M | $22.16 | 3.36x |
| J0897 | Injection, denosumab, 1 mg | 249.2K | $3.8M | $15.07 | 3.65x |
| J9271 | Injection, pembrolizumab, 1 mg | 88.8K | $3.7M | $41.71 | 3.33x |
| J2505 | Injection, pegfilgrastim, 6 mg | 662 | $2.0M | $3.1K | 5.09x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 19.4K | $1.6M | $83.47 | 2.65x |
| J9035 | Injection, bevacizumab, 10 mg | 16.5K | $1.0M | $62.63 | 3.42x |
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 8.7K | $926.0K | $106.49 | 6.29x |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | 315.1K | $872.9K | $2.77 | 7.56x |
| J1437 | Injection, ferric derisomaltose, 10 mg | 32.1K | $569.1K | $17.73 | 4.06x |
| J1439 | Injection, ferric carboxymaltose, 1 mg | 672.0K | $568.1K | $0.85 | 4.69x |
| J9144 | Injection, daratumumab, 10 mg and hyaluronidase-fihj | 14.8K | $558.1K | $37.81 | 3.59x |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | 41.9K | $360.9K | $8.61 | 5.80x |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 2.1K | $329.2K | $158.95 | 2.68x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 35.4K | $306.5K | $8.67 | 4.02x |
| 80053 | Blood test, comprehensive group of blood chemicals | 26.9K | $305.0K | $11.32 | 5.39x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 4.3K | $267.8K | $61.99 | 2.37x |
| J9041 | Injection, bortezomib, 0.1 mg | 6.6K | $241.1K | $36.45 | 3.40x |
| J9310 | Injection, rituximab, 100 mg | 334 | $235.3K | $704.57 | 3.52x |
| J2469 | Injection, palonosetron hcl, 25 mcg | 26.4K | $201.7K | $7.66 | 15.83x |
| 96375 | Injection of additional new drug or substance into vein | 11.8K | $165.9K | $14.00 | 7.46x |
This provider submits charges 4.36 times higher than what Medicare actually pays.
A markup ratio of 4.36x means for every $100 Medicare pays, this provider initially charges $436. 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 FL for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Christopher Lobo, MD | Port Charlotte, FL | $60.5M | ⚠️ Flagged |
| Maen Hussein, M.D. | Tavares, FL | $57.6M | ✓ Clear |
| Vikas Malhotra, M.D. | Spring Hill, FL | $52.8M | ✓ Clear |
| Andrew Lipman, M.D. | Naples, FL | $51.1M | ⚠️ Flagged |
| Syed Zafar, M.D. | Fort Myers, FL | $48.1M | ⚠️ Flagged |
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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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