This provider's $3.5M in total Medicare payments ranks in the 97th percentile of 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 | $205.59 | $70.41 | 2.92x | $135.18 | $286.8K | 4.4K | 3.3K |
| 2015 | $221.95 | $87.99 | 2.52x | $133.96 | $417.9K | 5.4K | 3.9K |
| 2016 | $209.03 | $88.93 | 2.35x | $120.10 | $400.3K | 4.8K | 3.2K |
| 2017 | $219.06 | $93.42 | 2.34x | $125.64 | $345.0K | 4.5K | 3.1K |
| 2018 | $229.16 | $97.12 | 2.36x | $132.04 | $341.8K | 5.0K | 3.4K |
| 2019 | $242.50 | $101.57 | 2.39x | $140.93 | $342.9K | 5.3K | 3.5K |
| 2020 | $216.74 | $95.36 | 2.27x | $121.38 | $314.5K | 4.5K | 3.2K |
| 2021 | $190.63 | $82.55 | 2.31x | $108.08 | $362.2K | 4.9K | 3.3K |
| 2022 | $315.61 | $82.32 | 3.83x | $233.29 | $333.9K | 4.8K | 3.4K |
| 2023 | $363.66 | $85.83 | 4.24x | $277.83 | $367.3K | 5.6K | 3.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 11.2K | $973.0K | $86.88 | 2.08x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 1.7K | $673.7K | $406.36 | 2.63x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 3.6K | $578.9K | $162.43 | 3.90x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 2.4K | $145.6K | $59.46 | 1.61x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.0K | $132.7K | $126.99 | 2.40x |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 1.6K | $118.6K | $72.41 | 4.12x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 9.1K | $113.9K | $12.55 | 4.74x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 657 | $103.0K | $156.72 | 2.12x |
| 93229 | Heart rhythm tracing, computer analysis, physician prescribed transmission of patient-triggered events greater than 24-hour EKG up to 30 days | 167 | $101.4K | $607.23 | 1.52x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 1.6K | $88.9K | $54.24 | 6.13x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 773 | $85.6K | $110.73 | 1.76x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 572 | $52.3K | $91.42 | 2.32x |
| 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 6.7K | $45.6K | $6.84 | 4.03x |
| 93295 | Remote evaluations of single, dual, or multiple lead cardioverter-defibrillator with physician analysis, review, and report up to 90 days | 959 | $36.2K | $37.76 | 3.07x |
| J2785 | Injection, regadenoson, 0.1 mg | 645 | $29.5K | $45.78 | 2.25x |
| 93247 | Heart rhythm analysis and report of continous external ekg over 8-15 days | 124 | $23.8K | $191.98 | 5.87x |
| 93294 | Remote evaluations of single, dual, or multiple lead pacemaker with physician analysis, review, and report up to 90 days | 906 | $21.7K | $23.91 | 4.30x |
| 99220 | Hospital observation care typically 70 minutes per day | 150 | $21.3K | $141.83 | 1.76x |
| 93280 | Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report | 703 | $20.7K | $29.49 | 4.01x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 120 | $19.7K | $164.57 | 1.91x |
This provider submits charges 2.84 times higher than what Medicare actually pays.
A markup ratio of 2.84x means for every $100 Medicare pays, this provider initially charges $284. 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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