NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
Q5122 Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg HCPCS · Treatment
Classification Treatment › Injections and Infusions (nononcologic) › Injection - Colony Stimulating Factors (CMS RBCS)
First observed 2021
National scale 21,968 services ▼ 81.4% YoY · 993 beneficiaries (CY2024, Medicare FFS)
Medicare paid $1.3M · $57.46 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

19

Named groups billing this code
Named-group all-Medicare svcs · est.

36,700

Scaled from 19,814 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

-81.3%

All-Medicare est. · observed FFS -81.4%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~36,700 services

19,814 observed fee-for-service (54%) · ~16,886 estimated Medicare Advantage.

Scaled from the observed floor by each state’s fee-for-service share (FFS share as of 2024) — scaled estimate — assumes MA utilization mirrors FFS; not an observation. How we scale
Top states — Q5122 (CY2024)
IL 6,198 SC 3,328 VA 3,204 MD 2,460 MN 2,400

Disclosed Medicare fee-for-service services by billing state; open a bar for that state's ranked market.

Billed → allowed → paid
Named-group submitted charges
$16.1M
Named-group allowed amount
$1.4M
Named-group Medicare payments
$1.1M
Avg charge / svc
$813
Avg allowed / svc
$72
Avg payment / svc
$57
Totals are named-group (attributable) sums. Allowed is Medicare’s fee-schedule recognized price — what CMS recognizes, before the 80% Medicare pays.
Average charge per group
$0 19 groups · avg submitted charge / service $879
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers Q5122 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 ILLINOIS CANCER SPECIALISTS ARLINGTON HEIGHTS IL HEMATOLOGY/ONCOLOGY 29 6,198 $5,109,792 $824 100.0% (847) 259-4482
2 MARYLAND ONCOLOGY HEMATOLOGY PA LAUREL MD HEMATOLOGY/ONCOLOGY 99 2,460 $2,162,340 $879 100.0% (301) 982-9800
3 MINNESOTA ONCOLOGY HEMATOLOGY PA EDINA MN PHYSICIAN ASSISTANT 135 1,776 $1,561,104 $879 74.0% (952) 928-2900
4 VIRGINIA ONCOLOGY ASSOCIATES NORFOLK VA PHYSICIAN ASSISTANT 123 1,500 $1,318,500 $879 46.8% —
5 SOUTH CAROLINA ONCOLOGY ASSOC PA COLUMBIA SC HEMATOLOGY/ONCOLOGY 18 1,320 $777,480 $589 39.7% (803) 461-3000
That's the top 5 of 19 groups. The platform ranks the whole market — code baskets, benchmarks, and the full ranked list. the full ranking is part of the market analytics platform — built, not launched yet. Notify me at launch →

*Share of the state's disclosed Medicare-FFS services for the primary code, counted once per clinician. "St" is the state the volume was billed from: a group appears in each state where its clinicians bill Medicare, with that state's volume and share ("City" is the group's registered location). Group figures sum clinicians affiliated with exactly one group; clinicians in several groups are listed in each group's drill-down but not volume-attributed to any single group, so shares reflect attributable volume. See Methods.

Comparing against an all-payer estimate?

These are exact counts from Medicare fee-for-service claims — roughly a third to half of most procedure markets, depending on payer mix. Modeled all-payer databases project the remainder statistically; we publish the audited floor and label it as such. Same market, different denominator. How the numbers reconcile →