This provider's $4.5M in total Medicare payments ranks in the 99th percentile of Advanced Heart Failure and Transplant Cardiology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
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 | $326.55 | $86.99 | 3.75x | $239.56 | $364.3K | 4.0K | 3.3K |
| 2015 | $325.84 | $86.10 | 3.78x | $239.74 | $384.6K | 4.5K | 4.0K |
| 2016 | $305.86 | $88.99 | 3.44x | $216.87 | $459.8K | 7.2K | 5.8K |
| 2017 | $282.32 | $87.29 | 3.23x | $195.03 | $507.0K | 7.8K | 6.3K |
| 2018 | $352.30 | $115.09 | 3.06x | $237.21 | $474.9K | 7.6K | 5.8K |
| 2019 | $343.74 | $115.93 | 2.97x | $227.81 | $484.0K | 7.0K | 5.4K |
| 2020 | $330.01 | $112.82 | 2.93x | $217.19 | $491.8K | 6.6K | 5.1K |
| 2021 | $311.13 | $106.46 | 2.92x | $204.67 | $462.2K | 6.1K | 4.9K |
| 2022 | $298.43 | $99.11 | 3.01x | $199.32 | $422.1K | 6.3K | 4.7K |
| 2023 | $395.56 | $136.32 | 2.90x | $259.24 | $484.8K | 7.8K | 5.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 2.5K | $799.1K | $320.14 | 3.76x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 7.3K | $588.5K | $80.47 | 2.30x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 3.4K | $387.3K | $112.56 | 5.22x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 2.4K | $353.6K | $148.43 | 3.47x |
| 78492 | Nuclear medicine study heart muscle at rest and/or stress multiple studies | 331 | $349.4K | $1.1K | 2.48x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 5.8K | $327.2K | $56.62 | 2.21x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.9K | $286.6K | $151.71 | 2.37x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 4.2K | $154.4K | $36.99 | 2.30x |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 2.1K | $134.5K | $64.64 | 3.21x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 2.5K | $130.1K | $51.81 | 5.60x |
| 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 15.8K | $100.5K | $6.35 | 13.17x |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | 342 | $79.9K | $233.53 | 2.51x |
| J2785 | Injection, regadenoson, 0.1 mg | 1.8K | $77.3K | $44.07 | 2.23x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 941 | $75.1K | $79.82 | 2.23x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 710 | $74.6K | $105.06 | 2.33x |
| 93970 | Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers | 476 | $70.4K | $147.81 | 3.32x |
| 93925 | Ultrasound study of arteries and arterial grafts of both legs | 369 | $68.0K | $184.33 | 2.52x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 1.2K | $48.0K | $39.63 | 3.28x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 3.9K | $43.6K | $11.23 | 5.79x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 604 | $43.4K | $71.94 | 2.57x |
This provider submits charges 3.4 times higher than what Medicare actually pays.
A markup ratio of 3.4x means for every $100 Medicare pays, this provider initially charges $340. 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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