This provider's $8.8M in total Medicare payments ranks in the 99th percentile of Cardiology providers nationally.
Medicare payments to this provider grew 198% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 359% in 2021
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 |
|---|---|---|---|---|---|---|---|
| 2014 | $327.07 | $75.27 | 4.35x | $251.80 | $655.5K | 8.1K | 6.5K |
| 2015 | $377.21 | $89.11 | 4.23x | $288.10 | $610.4K | 7.1K | 5.7K |
| 2016 | $399.17 | $91.97 | 4.34x | $307.20 | $588.5K | 7.5K | 5.9K |
| 2017 | $370.82 | $86.72 | 4.28x | $284.10 | $616.7K | 8.1K | 6.0K |
| 2018 | $405.51 | $94.83 | 4.28x | $310.68 | $669.6K | 8.2K | 6.3K |
| 2019 | $523.24 | $152.60 | 3.43x | $370.64 | $812.6K | 7.9K | 6.4K |
| 2020 | $546.78 | $191.55 | 2.85x | $355.23 | $264.1K | 1.5K | 1.5K |
| 2021 | $457.24 | $137.06 | 3.34x | $320.18 | $1.2M | 8.2K | 6.7K |
| 2022 | $568.57 | $180.60 | 3.15x | $387.97 | $1.4M | 8.2K | 6.9K |
| 2023 | $530.16 | $152.96 | 3.47x | $377.20 | $2.0M | 8.8K | 7.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 78431 | Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent ct scan | 797 | $1.5M | $1.9K | 1.91x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 14.0K | $1.2M | $84.35 | 2.70x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 2.9K | $1.1M | $387.32 | 6.20x |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | 1.5K | $903.1K | $616.04 | 1.91x |
| 78492 | Nuclear medicine study heart muscle at rest and/or stress multiple studies | 659 | $808.9K | $1.2K | 1.30x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 5.6K | $713.9K | $128.51 | 6.64x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 2.9K | $325.2K | $112.07 | 2.76x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 4.5K | $264.7K | $59.08 | 4.47x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 4.0K | $227.1K | $57.39 | 2.81x |
| 78434 | Nuclear medicine absolute quantification of blood flow in heart muscle | 1.2K | $183.4K | $149.23 | 7.91x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 1.6K | $170.2K | $104.53 | 2.87x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 2.0K | $166.4K | $83.45 | 2.76x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 13.0K | $158.6K | $12.20 | 5.08x |
| J2785 | Injection, regadenoson, 0.1 mg | 3.2K | $143.0K | $44.28 | 2.99x |
| 93229 | Heart rhythm tracing, computer analysis, physician prescribed transmission of patient-triggered events greater than 24-hour EKG up to 30 days | 225 | $139.2K | $618.60 | 3.14x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 983 | $119.8K | $121.89 | 2.92x |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 1.6K | $107.0K | $67.57 | 11.62x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 616 | $98.5K | $159.87 | 2.74x |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | 1.3K | $69.6K | $53.24 | 14.84x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 270 | $40.4K | $149.53 | 2.98x |
This provider submits charges 3.61 times higher than what Medicare actually pays.
A markup ratio of 3.61x means for every $100 Medicare pays, this provider initially charges $361. 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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