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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Providers
  3. Pankaj Lal
❤️
MDIndividual

Pankaj Lal, M.D.

NPI: 1538132873
Rockville, MD
10 years of data
Cardiology
$6.5M
Total Payments
40.6K
Beneficiaries
49.2K
Services
2.56x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$6.5M
Specialty median$193.1K

📋 Key Findings

1Billed $6.5M over 10 years
22.56x markup ratio (above median)
399th percentile in Cardiology by payments
45 procedures with >3x markup
✓ No flags detected

🔎 Data Analysis

This provider's $6.5M in total Medicare payments ranks in the 99th percentile of Cardiology providers nationally.

Medicare payments to this provider grew 84% from 2014 to 2023.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$326.42$131.272.49x$195.15$468.4K4.1K3.6K
2015$268.05$107.752.49x$160.30$544.1K4.2K3.7K
2016$301.89$115.572.61x$186.32$609.3K4.7K4.1K
2017$297.25$115.652.57x$181.60$513.2K3.5K3.2K
2018$313.14$122.602.55x$190.54$656.0K5.2K3.9K
2019$318.18$118.952.67x$199.23$692.0K5.2K4.1K
2020$276.40$108.282.55x$168.12$589.9K4.4K3.6K
2021$242.47$107.632.25x$134.84$790.2K5.8K4.7K
2022$252.98$98.392.57x$154.59$792.8K6.1K4.7K
2023$310.19$128.012.42x$182.18$860.7K6.1K4.8K

Top Procedures (20)

78452Nuclear medicine study of vessels of heart using drugs or exercise multiple studies
$2.1M
4.7K services$445.21/svc2.25x markup
93306Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function
$1.3M
7.7K services$161.93/svc2.73x markup
93880Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck
$543.3K
3.3K services$165.03/svc2.41x markup
99213Established patient office or other outpatient visit, typically 15 minutes
$354.6K
5.4K services$65.35/svc2.06x markup
A9500Technetium tc-99m sestamibi, diagnostic, per study dose⚠ 4.6x markup
$345.4K
2.8K services$122.78/svc4.59x markup
99214Established patient office or other outpatient, visit typically 25 minutes
$327.3K
3.6K services$90.19/svc1.92x markup
93925Ultrasound study of arteries and arterial grafts of both legs
$295.3K
1.3K services$223.03/svc2.00x markup
93015Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report⚠ 3.5x markup
$269.6K
4.7K services$57.37/svc3.49x markup
99204New patient office or other outpatient visit, typically 45 minutes
$242.1K
1.8K services$132.23/svc1.70x markup
A9502Technetium tc-99m tetrofosmin, diagnostic, per study dose⚠ 5.2x markup
$187.2K
1.8K services$101.56/svc5.23x markup
93229Heart rhythm tracing, computer analysis, physician prescribed transmission of patient-triggered events greater than 24-hour EKG up to 30 days
$123.5K
158 services$781.36/svc1.81x markup
99490Chronic care management services at least 20 minutes per calendar month
$112.7K
3.1K services$35.84/svc1.81x markup
93970Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers
$102.2K
638 services$160.25/svc2.79x markup
99454Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days
$59.4K
1.1K services$54.37/svc1.58x markup
99203New patient office or other outpatient visit, typically 30 minutes
$49.4K
541 services$91.27/svc1.64x markup
93923Ultrasound study of arteries of both arms and legs
$26.2K
249 services$105.17/svc2.85x markup
99222Initial hospital inpatient care, typically 50 minutes per day
$22.3K
194 services$115.01/svc2.17x markup
99457Remote physiologic monitoring treatment management services, health care professional time in a calendar month requiring interactive communication with the patient/caregiver; first 20 minutes
$20.2K
451 services$44.81/svc1.52x markup
93224Heart rhythm tracing, analysis, and interpretation of 48-hour EKG⚠ 3.6x markup
$19.1K
279 services$68.54/svc3.64x markup
93000Routine EKG using at least 12 leads including interpretation and report⚠ 4.4x markup
$14.8K
1.2K services$12.44/svc4.42x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
78452Nuclear medicine study of vessels of heart using drugs or exercise multiple studies4.7K$2.1M$445.212.25x
93306Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function7.7K$1.3M$161.932.73x
93880Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck3.3K$543.3K$165.032.41x
99213Established patient office or other outpatient visit, typically 15 minutes5.4K$354.6K$65.352.06x
A9500Technetium tc-99m sestamibi, diagnostic, per study dose2.8K$345.4K$122.784.59x
99214Established patient office or other outpatient, visit typically 25 minutes3.6K$327.3K$90.191.92x
93925Ultrasound study of arteries and arterial grafts of both legs1.3K$295.3K$223.032.00x
93015Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report4.7K$269.6K$57.373.49x
99204New patient office or other outpatient visit, typically 45 minutes1.8K$242.1K$132.231.70x
A9502Technetium tc-99m tetrofosmin, diagnostic, per study dose1.8K$187.2K$101.565.23x
93229Heart rhythm tracing, computer analysis, physician prescribed transmission of patient-triggered events greater than 24-hour EKG up to 30 days158$123.5K$781.361.81x
99490Chronic care management services at least 20 minutes per calendar month3.1K$112.7K$35.841.81x
93970Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers638$102.2K$160.252.79x
99454Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days1.1K$59.4K$54.371.58x
99203New patient office or other outpatient visit, typically 30 minutes541$49.4K$91.271.64x
93923Ultrasound study of arteries of both arms and legs249$26.2K$105.172.85x
99222Initial hospital inpatient care, typically 50 minutes per day194$22.3K$115.012.17x
99457Remote physiologic monitoring treatment management services, health care professional time in a calendar month requiring interactive communication with the patient/caregiver; first 20 minutes451$20.2K$44.811.52x
93224Heart rhythm tracing, analysis, and interpretation of 48-hour EKG279$19.1K$68.543.64x
93000Routine EKG using at least 12 leads including interpretation and report1.2K$14.8K$12.444.42x

Markup Analysis

Charge-to-Payment Ratio

2.56x

This provider submits charges 2.56 times higher than what Medicare actually pays.

What This Means

A markup ratio of 2.56x means for every $100 Medicare pays, this provider initially charges $256. This is higher than the national average.

Location

Rockville, MD

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

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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