This provider's $8.8M in total Medicare payments ranks in the 99th percentile of Cardiology providers nationally.
Medicare payments to this provider grew 666% from 2017 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 290% in 2018
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 |
|---|---|---|---|---|---|---|---|
| 2017 | $409.23 | $162.64 | 2.52x | $246.59 | $267.9K | 1.4K | 1.3K |
| 2018 | $351.80 | $133.47 | 2.64x | $218.33 | $1.0M | 5.3K | 4.8K |
| 2019 | $370.04 | $140.14 | 2.64x | $229.90 | $910.6K | 5.3K | 4.3K |
| 2020 | $418.22 | $162.55 | 2.57x | $255.67 | $1.5M | 6.6K | 5.8K |
| 2021 | $419.12 | $162.52 | 2.58x | $256.60 | $1.5M | 7.6K | 6.6K |
| 2022 | $506.49 | $198.51 | 2.55x | $307.98 | $1.5M | 7.3K | 6.3K |
| 2023 | $498.49 | $189.09 | 2.64x | $309.40 | $2.1M | 8.8K | 7.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 78431 | Multiple nuclear medicine studies of blood flow in heart muscle at rest and with stress, with concurrently acquired ct transmission scan | 2.0K | $3.9M | $2.0K | 2.55x |
| 78492 | Nuclear medicine study heart muscle at rest and/or stress multiple studies | 988 | $1.2M | $1.2K | 2.51x |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | 3.0K | $935.3K | $313.95 | 2.56x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 6.0K | $711.9K | $118.80 | 2.65x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.8K | $630.8K | $92.27 | 2.76x |
| 78434 | Nuclear medicine absolute quantification of blood flow in heart muscle | 1.9K | $282.8K | $147.51 | 2.53x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.0K | $246.3K | $123.04 | 2.84x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 3.3K | $186.5K | $57.16 | 2.59x |
| J2785 | Injection, regadenoson, 0.1 mg | 2.9K | $132.8K | $45.70 | 2.56x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 729 | $120.5K | $165.34 | 2.55x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 1.2K | $108.6K | $86.98 | 2.50x |
| 93229 | Heart rhythm tracing, computer analysis, physician prescribed transmission of patient-triggered events greater than 24-hour EKG up to 30 days | 171 | $106.4K | $621.98 | 2.63x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 7.8K | $93.4K | $11.97 | 2.80x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 368 | $71.9K | $195.39 | 2.59x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 639 | $37.1K | $58.09 | 2.85x |
| 99220 | Hospital observation care typically 70 minutes per day | 192 | $29.1K | $151.41 | 2.56x |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | 162 | $27.3K | $168.76 | 2.27x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 213 | $12.9K | $60.45 | 2.53x |
| 93312 | Insertion of probe in esophagus for heart ultrasound examination including interpretation and report | 130 | $11.4K | $87.87 | 2.58x |
| 93224 | Heart rhythm tracing, analysis, and interpretation of 48-hour EKG | 173 | $10.1K | $58.23 | 2.90x |
This provider submits charges 2.58 times higher than what Medicare actually pays.
A markup ratio of 2.58x means for every $100 Medicare pays, this provider initially charges $258. 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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