This provider's $4.3M in total Medicare payments ranks in the 98th 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 | $257.04 | $63.10 | 4.07x | $193.94 | $458.8K | 9.5K | 7.6K |
| 2015 | $270.80 | $68.89 | 3.93x | $201.91 | $403.7K | 9.9K | 7.0K |
| 2016 | $230.24 | $55.88 | 4.12x | $174.36 | $580.5K | 14.6K | 9.4K |
| 2017 | $254.65 | $61.97 | 4.11x | $192.68 | $492.2K | 11.2K | 7.3K |
| 2018 | $265.98 | $63.14 | 4.21x | $202.84 | $474.1K | 11.0K | 7.2K |
| 2019 | $231.68 | $55.35 | 4.19x | $176.33 | $414.3K | 9.9K | 6.6K |
| 2020 | $269.05 | $64.52 | 4.17x | $204.53 | $409.3K | 9.5K | 6.5K |
| 2021 | $272.85 | $65.20 | 4.18x | $207.65 | $462.0K | 9.2K | 6.5K |
| 2022 | $247.46 | $56.93 | 4.35x | $190.53 | $373.9K | 7.8K | 5.5K |
| 2023 | $220.21 | $44.48 | 4.95x | $175.73 | $203.8K | 4.5K | 3.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 2.4K | $803.3K | $330.15 | 3.29x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 8.1K | $722.5K | $89.30 | 4.95x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.6K | $500.0K | $76.13 | 2.56x |
| G0249 | Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the | 7.4K | $404.1K | $54.41 | 5.82x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.5K | $354.5K | $47.21 | 2.48x |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 2.3K | $166.4K | $70.87 | 1.30x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.4K | $148.4K | $105.60 | 3.22x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 2.5K | $117.7K | $46.39 | 7.17x |
| 93294 | Remote evaluations of single, dual, or multiple lead pacemaker with physician analysis, review, and report up to 90 days | 5.1K | $101.1K | $19.82 | 5.22x |
| 93296 | Remote evaluations of single, dual, or multiple lead pacemaker or cardioverter-defibrillator transmissions, technician review, support, and distribution of results up to 90 days | 6.7K | $99.6K | $14.97 | 6.85x |
| 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 15.5K | $98.8K | $6.37 | 5.32x |
| J2785 | Injection, regadenoson, 0.1 mg | 1.5K | $60.2K | $40.87 | 1.29x |
| 93295 | Remote evaluations of single, dual, or multiple lead cardioverter-defibrillator with physician analysis, review, and report up to 90 days | 1.6K | $54.2K | $33.76 | 5.55x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 4.0K | $50.6K | $12.81 | 3.80x |
| 93280 | Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report | 1.1K | $46.0K | $40.99 | 4.49x |
| G0250 | Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequent | 7.2K | $44.6K | $6.23 | 4.17x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 303 | $44.1K | $145.58 | 2.88x |
| 33208 | Insertion of new or replacement of permanent pacemaker including upper and lower chamber electrodes | 105 | $38.4K | $365.46 | 4.36x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 3.5K | $32.9K | $9.54 | 8.56x |
| 93308 | Follow-up or limited ultrasound examination of heart | 590 | $29.2K | $49.43 | 4.98x |
This provider submits charges 4.05 times higher than what Medicare actually pays.
A markup ratio of 4.05x means for every $100 Medicare pays, this provider initially charges $405. 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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