This provider's $5.0M in total Medicare payments ranks in the 97th percentile of Medical Oncology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 89% in 2015
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 | $216.95 | $83.40 | 2.60x | $133.55 | $464.0K | 8.7K | 2.7K |
| 2015 | $239.26 | $92.79 | 2.58x | $146.47 | $877.7K | 14.3K | 3.2K |
| 2016 | $249.69 | $96.67 | 2.58x | $153.02 | $567.3K | 11.7K | 2.7K |
| 2017 | $295.92 | $114.10 | 2.59x | $181.82 | $532.9K | 9.9K | 2.4K |
| 2018 | $438.83 | $150.85 | 2.91x | $287.98 | $805.1K | 11.0K | 2.7K |
| 2019 | $143.09 | $54.83 | 2.61x | $88.26 | $434.2K | 9.6K | 2.6K |
| 2020 | $247.40 | $85.61 | 2.89x | $161.79 | $321.8K | 9.0K | 2.2K |
| 2021 | $98.05 | $39.51 | 2.48x | $58.54 | $323.0K | 9.1K | 2.2K |
| 2022 | $108.93 | $40.04 | 2.72x | $68.89 | $325.6K | 8.2K | 2.4K |
| 2023 | $101.35 | $37.12 | 2.73x | $64.23 | $353.6K | 8.6K | 2.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2505 | Injection, pegfilgrastim, 6 mg | 419 | $1.3M | $3.0K | 2.56x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 9.1K | $774.1K | $85.08 | 2.62x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 6.4K | $624.2K | $97.40 | 2.58x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 8.3K | $450.9K | $54.21 | 2.66x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.1K | $162.8K | $152.72 | 2.60x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 17.7K | $157.1K | $8.87 | 2.25x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 971 | $149.4K | $153.82 | 2.65x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.9K | $149.0K | $79.09 | 2.56x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 2.6K | $143.5K | $54.81 | 2.57x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 2.0K | $94.5K | $46.57 | 2.61x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 1.6K | $75.5K | $47.73 | 2.69x |
| J1454 | Injection, fosnetupitant 235 mg and palonosetron 0.25 mg | 209 | $69.7K | $333.31 | 2.56x |
| J3490 | Unclassified drugs | 47 | $62.0K | $1.3K | 4.42x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 531 | $56.8K | $106.97 | 2.60x |
| 96401 | Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle | 1.0K | $55.2K | $54.09 | 2.62x |
| 96375 | Injection of different drug or substance into a vein for therapy, diagnosis, or prevention | 4.0K | $54.4K | $13.70 | 2.65x |
| J9310 | Injection, rituximab, 100 mg | 85 | $52.8K | $621.59 | 2.56x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 2.2K | $48.0K | $22.00 | 2.63x |
| G0498 | Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted l | 403 | $45.6K | $113.06 | 2.43x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 3.2K | $45.4K | $14.07 | 2.64x |
This provider submits charges 2.62 times higher than what Medicare actually pays.
A markup ratio of 2.62x means for every $100 Medicare pays, this provider initially charges $262. 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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