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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Providers
  3. Prabal Guha
⚕️
MDIndividual

Prabal Guha, M.D.

NPI: 1043277304
Florence, SC
10 years of data
Clinical Cardiac Electrophysiology
$4.8M
Total Payments
59.8K
Beneficiaries
99.6K
Services
4.51x
Markup Ratio

Peer Comparison

98th
percentile in specialty
This provider$4.8M
Specialty median$207.8K

📋 Key Findings

1Billed $4.8M over 10 years
24.51x markup ratio (above median)
398th percentile in Clinical Cardiac Electrophysiology by payments
414 procedures with >3x markup
✓ No flags detected

🔎 Data Analysis

This provider's $4.8M in total Medicare payments ranks in the 98th percentile of Clinical Cardiac Electrophysiology providers nationally.

This provider's billing patterns fall within normal ranges for their specialty.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$489.45$101.784.81x$387.67$309.5K5.4K4.1K
2015$684.48$135.235.06x$549.25$375.2K6.1K4.5K
2016$730.34$136.875.34x$593.47$391.2K6.8K4.8K
2017$778.70$145.985.33x$632.72$455.0K8.4K5.4K
2018$611.60$114.445.34x$497.16$498.9K10.4K6.5K
2019$721.65$136.705.28x$584.95$652.6K14.5K8.7K
2020$710.87$142.964.97x$567.91$653.6K15.6K8.7K
2021$770.04$154.005.00x$616.04$548.7K12.5K6.2K
2022$698.68$143.254.88x$555.43$485.6K10.7K5.8K
2023$661.24$126.075.25x$535.17$450.9K9.3K5.0K

Top Procedures (20)

99214Established patient office or other outpatient, visit typically 25 minutes
$834.3K
11.0K services$76.16/svc2.06x markup
93294Remote evaluations of single, dual, or multiple lead pacemaker with physician analysis, review, and report up to 90 days⚠ 4.3x markup
$307.7K
14.3K services$21.47/svc4.28x markup
93295Remote evaluations of single, dual, or multiple lead cardioverter-defibrillator with physician analysis, review, and report up to 90 days⚠ 5.6x markup
$278.8K
9.4K services$29.62/svc5.60x markup
33249Insertion or replacement of single or dual chamber pacing defibrillator leads⚠ 5.8x markup
$253.8K
371 services$683.98/svc5.79x markup
99232Subsequent hospital inpatient care, typically 25 minutes per day
$236.4K
4.3K services$55.14/svc2.60x markup
99223Initial hospital inpatient care, typically 70 minutes per day
$219.7K
1.5K services$149.76/svc2.57x markup
93656Evaluation and insertion of catheters for recording, pacing, and treatment of abnormal heart rhythm⚠ 5.8x markup
$213.1K
260 services$819.48/svc5.80x markup
33208Insertion of new or replacement of permanent pacemaker including upper and lower chamber electrodes⚠ 6.1x markup
$185.4K
482 services$384.60/svc6.09x markup
93280Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report⚠ 3.4x markup
$177.3K
3.8K services$47.13/svc3.37x markup
93298Remote evaluations of implantable heart recorder system including physician analysis, review, and report up to 30 days⚠ 3.9x markup
$174.9K
9.1K services$19.20/svc3.85x markup
93000Routine EKG using at least 12 leads including interpretation and report⚠ 8.2x markup
$155.3K
13.8K services$11.28/svc8.24x markup
93296Remote evaluations of single, dual, or multiple lead pacemaker or cardioverter-defibrillator transmissions, technician review, support, and distribution of results up to 90 days⚠ 5.3x markup
$134.3K
8.3K services$16.10/svc5.34x markup
93306Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function⚠ 18.4x markup
$130.2K
2.7K services$48.67/svc18.45x markup
93653Evaluation and insertion of catheters for creation of complete heart block⚠ 5.7x markup
$108.4K
173 services$626.54/svc5.68x markup
99233Subsequent hospital inpatient care, typically 35 minutes per day
$106.5K
1.4K services$78.74/svc2.58x markup
93283Evaluation, testing, and programming adjustment of permanent dual lead cardioverter-defibrillator including physician analysis, review, and report⚠ 3.5x markup
$81.0K
1.3K services$60.16/svc3.49x markup
99205New patient office or other outpatient visit, typically 60 minutes
$80.9K
535 services$151.18/svc2.53x markup
99215Established patient office or other outpatient, visit typically 40 minutes
$80.8K
799 services$101.18/svc2.13x markup
93613Insertion of catheters for 3D mapping of electrical impulses to heart muscles⚠ 4.7x markup
$79.8K
310 services$257.40/svc4.68x markup
93284Evaluation, testing, and programming adjustment of permanent multiple lead cardioverter-defibrillator including physician analysis, review, and report⚠ 3.6x markup
$78.4K
1.2K services$66.52/svc3.65x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
99214Established patient office or other outpatient, visit typically 25 minutes11.0K$834.3K$76.162.06x
93294Remote evaluations of single, dual, or multiple lead pacemaker with physician analysis, review, and report up to 90 days14.3K$307.7K$21.474.28x
93295Remote evaluations of single, dual, or multiple lead cardioverter-defibrillator with physician analysis, review, and report up to 90 days9.4K$278.8K$29.625.60x
33249Insertion or replacement of single or dual chamber pacing defibrillator leads371$253.8K$683.985.79x
99232Subsequent hospital inpatient care, typically 25 minutes per day4.3K$236.4K$55.142.60x
99223Initial hospital inpatient care, typically 70 minutes per day1.5K$219.7K$149.762.57x
93656Evaluation and insertion of catheters for recording, pacing, and treatment of abnormal heart rhythm260$213.1K$819.485.80x
33208Insertion of new or replacement of permanent pacemaker including upper and lower chamber electrodes482$185.4K$384.606.09x
93280Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report3.8K$177.3K$47.133.37x
93298Remote evaluations of implantable heart recorder system including physician analysis, review, and report up to 30 days9.1K$174.9K$19.203.85x
93000Routine EKG using at least 12 leads including interpretation and report13.8K$155.3K$11.288.24x
93296Remote evaluations of single, dual, or multiple lead pacemaker or cardioverter-defibrillator transmissions, technician review, support, and distribution of results up to 90 days8.3K$134.3K$16.105.34x
93306Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function2.7K$130.2K$48.6718.45x
93653Evaluation and insertion of catheters for creation of complete heart block173$108.4K$626.545.68x
99233Subsequent hospital inpatient care, typically 35 minutes per day1.4K$106.5K$78.742.58x
93283Evaluation, testing, and programming adjustment of permanent dual lead cardioverter-defibrillator including physician analysis, review, and report1.3K$81.0K$60.163.49x
99205New patient office or other outpatient visit, typically 60 minutes535$80.9K$151.182.53x
99215Established patient office or other outpatient, visit typically 40 minutes799$80.8K$101.182.13x
93613Insertion of catheters for 3D mapping of electrical impulses to heart muscles310$79.8K$257.404.68x
93284Evaluation, testing, and programming adjustment of permanent multiple lead cardioverter-defibrillator including physician analysis, review, and report1.2K$78.4K$66.523.65x

Markup Analysis

Charge-to-Payment Ratio

4.51x

This provider submits charges 4.51 times higher than what Medicare actually pays.

What This Means

A markup ratio of 4.51x means for every $100 Medicare pays, this provider initially charges $451. This is higher than the national average.

Location

Florence, SC

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

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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