This provider's $3.8M in total Medicare payments ranks in the 98th percentile of Hematology providers nationally.
Their average markup ratio of 6.2x is significantly above the specialty median of 3.8x.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 147% in 2023
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 | $631.75 | $95.90 | 6.59x | $535.85 | $449.5K | 7.2K | 2.7K |
| 2015 | $657.54 | $99.88 | 6.58x | $557.66 | $441.2K | 6.7K | 2.1K |
| 2016 | $650.10 | $100.30 | 6.48x | $549.80 | $456.0K | 6.0K | 1.9K |
| 2017 | $685.42 | $105.07 | 6.52x | $580.35 | $442.5K | 5.8K | 2.0K |
| 2018 | $729.57 | $118.45 | 6.16x | $611.12 | $626.6K | 6.2K | 2.2K |
| 2019 | $691.41 | $110.53 | 6.26x | $580.88 | $542.7K | 6.6K | 2.1K |
| 2020 | $710.85 | $99.51 | 7.14x | $611.34 | $392.2K | 5.0K | 1.7K |
| 2021 | $819.83 | $89.43 | 9.17x | $730.40 | $273.4K | 3.9K | 1.2K |
| 2022 | $294.57 | $43.15 | 6.83x | $251.42 | $56.4K | 1.2K | 636 |
| 2023 | $438.59 | $37.64 | 11.65x | $400.95 | $139.1K | 3.3K | 1.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2505 | Injection, pegfilgrastim, 6 mg | 524 | $1.6M | $3.0K | 6.56x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.8K | $513.2K | $75.98 | 4.31x |
| G9678 | Oncology Care Model service | 2.4K | $382.7K | $157.24 | 1.02x |
| 96413 | Infusion of chemotherapy into a vein up to 1 hour | 3.0K | $302.7K | $101.13 | 6.52x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.9K | $216.0K | $54.70 | 4.20x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.1K | $116.0K | $105.86 | 4.35x |
| J9310 | Injection, rituximab, 100 mg | 127 | $79.2K | $623.40 | 6.02x |
| 96365 | Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour | 1.4K | $71.5K | $50.97 | 8.49x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 3.5K | $53.6K | $15.53 | 10.45x |
| 96417 | Infusion of different chemotherapy drug or substance into a vein up to 1 hour | 827 | $40.4K | $48.81 | 11.99x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 698 | $39.2K | $56.13 | 6.26x |
| 96375 | Injection of different drug or substance into a vein for therapy, diagnosis, or prevention | 2.4K | $35.0K | $14.37 | 16.59x |
| 36591 | Collection of blood specimen from a completely implantable venous access device | 1.7K | $28.8K | $16.92 | 1.66x |
| 96523 | Irrigation of implanted venous access drug delivery device | 1.6K | $26.2K | $16.80 | 14.97x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 160 | $24.0K | $150.09 | 4.75x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 758 | $22.9K | $30.27 | 6.31x |
| 96367 | Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour | 969 | $22.1K | $22.76 | 17.97x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 171 | $19.1K | $111.96 | 4.61x |
| 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 | 149 | $18.6K | $125.09 | 9.54x |
| 96360 | Hydration infusion into a vein 31 minutes to 1 hour | 548 | $18.6K | $33.96 | 11.26x |
This provider submits charges 6.2 times higher than what Medicare actually pays.
A markup ratio of 6.2x means for every $100 Medicare pays, this provider initially charges $620. 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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