This provider's $4.8M 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 | $260.97 | $60.58 | 4.31x | $200.39 | $432.7K | 9.3K | 5.6K |
| 2015 | $284.32 | $64.46 | 4.41x | $219.86 | $426.4K | 9.1K | 5.5K |
| 2016 | $277.50 | $65.71 | 4.22x | $211.79 | $436.3K | 8.1K | 5.0K |
| 2017 | $320.17 | $74.13 | 4.32x | $246.04 | $437.4K | 7.3K | 4.3K |
| 2018 | $376.78 | $82.43 | 4.57x | $294.35 | $439.5K | 7.4K | 4.3K |
| 2019 | $131.76 | $55.95 | 2.35x | $75.81 | $473.9K | 10.2K | 6.2K |
| 2020 | $73.82 | $53.51 | 1.38x | $20.31 | $492.7K | 10.9K | 6.8K |
| 2021 | $76.33 | $56.71 | 1.35x | $19.62 | $554.8K | 11.8K | 6.9K |
| 2022 | $76.59 | $55.20 | 1.39x | $21.39 | $560.3K | 12.3K | 7.2K |
| 2023 | $71.94 | $50.05 | 1.44x | $21.89 | $527.2K | 11.1K | 6.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 19.0K | $1.8M | $95.76 | 2.21x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 3.6K | $685.3K | $187.85 | 3.39x |
| 93351 | Ultrasound examination and continuous monitoring of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report | 2.0K | $440.1K | $222.16 | 3.96x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 22.3K | $304.8K | $13.70 | 4.89x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 3.4K | $217.3K | $64.34 | 2.29x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.6K | $214.6K | $59.90 | 2.80x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.1K | $152.5K | $143.69 | 1.93x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 686 | $120.2K | $175.16 | 3.11x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 819 | $99.9K | $121.96 | 2.71x |
| 93320 | Doppler ultrasound study of heart blood flow, valves, and chambers | 2.0K | $96.9K | $49.24 | 3.59x |
| 93224 | Heart rhythm tracing, analysis, and interpretation of 48-hour EKG | 1.3K | $91.2K | $69.27 | 4.68x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 4.6K | $83.5K | $18.04 | 1.41x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 5.7K | $77.5K | $13.59 | 1.75x |
| 80053 | Blood test, comprehensive group of blood chemicals | 5.8K | $60.6K | $10.47 | 1.66x |
| 93325 | Doppler ultrasound study of color-directed heart blood flow, rate, and valve function | 2.0K | $46.1K | $23.41 | 7.20x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 5.1K | $42.8K | $8.46 | 1.70x |
| 99235 | Hospital observation or inpatient care moderate severity, 50 minutes per day' | 236 | $35.2K | $149.29 | 3.48x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 395 | $34.6K | $87.64 | 2.77x |
| 36415 | Insertion of needle into vein for collection of blood sample | 8.7K | $31.0K | $3.55 | 2.77x |
| G0008 | Administration of influenza virus vaccine | 971 | $23.4K | $24.08 | 1.33x |
This provider submits charges 2.86 times higher than what Medicare actually pays.
A markup ratio of 2.86x means for every $100 Medicare pays, this provider initially charges $286. 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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