This provider's $6.5M in total Medicare payments ranks in the 97th percentile of Independent Diagnostic Testing Facility (IDTF) providers nationally.
Medicare payments to this provider grew 1444% from 2017 to 2023.
70% of their billing comes from a single procedure code (78815 — Nuclear medicine study with CT imaging skull base to mid-thigh).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 873% 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 | $2.7K | $771.58 | 3.54x | $2.0K | $86.7K | 115 | 115 |
| 2018 | $3.5K | $938.42 | 3.76x | $2.6K | $843.5K | 1.1K | 834 |
| 2019 | $3.5K | $949.12 | 3.72x | $2.6K | $924.1K | 1.2K | 888 |
| 2020 | $3.7K | $999.66 | 3.68x | $2.7K | $976.0K | 1.2K | 908 |
| 2021 | $3.2K | $849.18 | 3.72x | $2.3K | $1.1M | 1.3K | 965 |
| 2022 | $3.4K | $879.23 | 3.89x | $2.5K | $1.3M | 1.5K | 1.1K |
| 2023 | $3.4K | $888.20 | 3.86x | $2.5K | $1.3M | 1.5K | 1.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 78815 | Nuclear medicine study with CT imaging skull base to mid-thigh | 3.5K | $4.6M | $1.3K | 4.26x |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 3.7K | $1.4M | $375.33 | 2.30x |
| 78816 | Nuclear medicine study with CT imaging whole body | 363 | $474.9K | $1.3K | 4.16x |
| A9595 | Piflufolastat f-18, diagnostic, 1 millicurie | 133 | $62.8K | $472.54 | 1.28x |
| A9588 | Fluciclovine f-18, diagnostic, 1 millicurie | 22 | $7.1K | $323.36 | 1.55x |
This provider submits charges 3.8 times higher than what Medicare actually pays.
A markup ratio of 3.8x means for every $100 Medicare pays, this provider initially charges $380. 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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