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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. Hetal Gandhi
❤️
MDIndividual

Hetal Gandhi, M.D,F.A.C.C.

NPI: 1740446178
Crystal Lake, IL
10 years of data
Cardiology
$3.2M
Total Payments
29.7K
Beneficiaries
37.9K
Services
3.74x
Markup Ratio

Peer Comparison

97th
percentile in specialty
This provider$3.2M
Specialty median$193.1K

📋 Key Findings

1Billed $3.2M over 10 years
23.74x markup ratio (above median)
397th percentile in Cardiology by payments
49 procedures with >3x markup
✓ No flags detected

🔎 Data Analysis

This provider's $3.2M in total Medicare payments ranks in the 97th percentile of Cardiology providers nationally.

Medicare payments to this provider grew 122% 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$241.72$76.503.16x$165.22$211.0K2.9K1.9K
2015$308.59$91.653.37x$216.94$231.6K3.1K2.0K
2016$310.84$87.723.54x$223.12$216.5K2.9K1.9K
2017$287.75$74.713.85x$213.04$295.8K3.4K2.5K
2018$312.27$78.723.97x$233.55$340.0K3.9K3.0K
2019$299.10$76.203.93x$222.90$349.2K4.0K3.1K
2020$289.03$69.604.15x$219.43$326.3K3.9K3.4K
2021$283.32$70.574.01x$212.75$383.7K4.4K3.8K
2022$345.07$79.854.32x$265.22$423.8K4.9K4.2K
2023$328.62$74.194.43x$254.43$468.2K4.4K3.8K

Top Procedures (20)

78452Nuclear medicine study of vessels of heart using drugs or exercise multiple studies⚠ 4.6x markup
$586.6K
1.9K services$304.56/svc4.57x markup
99214Established patient office or other outpatient, visit typically 25 minutes
$511.6K
6.3K services$80.97/svc2.70x markup
93306Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function⚠ 5.3x markup
$423.6K
5.0K services$85.52/svc5.32x markup
99232Subsequent hospital inpatient care, typically 25 minutes per day
$343.2K
6.0K services$56.96/svc2.63x markup
99223Initial hospital inpatient care, typically 70 minutes per day
$329.5K
2.1K services$157.36/svc2.56x markup
A9502Technetium tc-99m tetrofosmin, diagnostic, per study dose⚠ 4.4x markup
$224.6K
1.7K services$134.51/svc4.43x markup
99233Subsequent hospital inpatient care, typically 35 minutes per day
$173.5K
2.1K services$83.75/svc2.67x markup
99204New patient office or other outpatient visit, typically 45 minutes
$108.8K
919 services$118.40/svc2.79x markup
93015Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report⚠ 6.8x markup
$67.9K
1.4K services$47.81/svc6.75x markup
93880Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck⚠ 5.1x markup
$62.6K
450 services$139.01/svc5.08x markup
J2785Injection, regadenoson, 0.1 mg
$53.6K
1.2K services$45.35/svc2.04x markup
99215Established patient office or other outpatient, visit typically 40 minutes
$45.1K
425 services$106.14/svc2.82x markup
99222Initial hospital inpatient care, typically 50 minutes per day
$44.5K
419 services$106.28/svc2.68x markup
99205New patient office or other outpatient visit, typically 60 minutes
$34.5K
242 services$142.62/svc2.94x markup
93925Ultrasound study of arteries and arterial grafts of both legs⚠ 5.0x markup
$31.2K
175 services$178.05/svc4.99x markup
99213Established patient office or other outpatient visit, typically 15 minutes
$26.1K
528 services$49.46/svc2.86x markup
93000Routine EKG using at least 12 leads including interpretation and report⚠ 7.3x markup
$24.6K
2.3K services$10.83/svc7.35x markup
99291Critical care delivery critically ill or injured patient, first 30-74 minutes
$23.5K
133 services$176.84/svc2.59x markup
93018Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician interpretation and report⚠ 4.5x markup
$13.6K
1.2K services$11.20/svc4.46x markup
93312Insertion of probe in esophagus for heart ultrasound examination including interpretation and report⚠ 3.9x markup
$13.0K
148 services$87.78/svc3.94x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
78452Nuclear medicine study of vessels of heart using drugs or exercise multiple studies1.9K$586.6K$304.564.57x
99214Established patient office or other outpatient, visit typically 25 minutes6.3K$511.6K$80.972.70x
93306Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function5.0K$423.6K$85.525.32x
99232Subsequent hospital inpatient care, typically 25 minutes per day6.0K$343.2K$56.962.63x
99223Initial hospital inpatient care, typically 70 minutes per day2.1K$329.5K$157.362.56x
A9502Technetium tc-99m tetrofosmin, diagnostic, per study dose1.7K$224.6K$134.514.43x
99233Subsequent hospital inpatient care, typically 35 minutes per day2.1K$173.5K$83.752.67x
99204New patient office or other outpatient visit, typically 45 minutes919$108.8K$118.402.79x
93015Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report1.4K$67.9K$47.816.75x
93880Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck450$62.6K$139.015.08x
J2785Injection, regadenoson, 0.1 mg1.2K$53.6K$45.352.04x
99215Established patient office or other outpatient, visit typically 40 minutes425$45.1K$106.142.82x
99222Initial hospital inpatient care, typically 50 minutes per day419$44.5K$106.282.68x
99205New patient office or other outpatient visit, typically 60 minutes242$34.5K$142.622.94x
93925Ultrasound study of arteries and arterial grafts of both legs175$31.2K$178.054.99x
99213Established patient office or other outpatient visit, typically 15 minutes528$26.1K$49.462.86x
93000Routine EKG using at least 12 leads including interpretation and report2.3K$24.6K$10.837.35x
99291Critical care delivery critically ill or injured patient, first 30-74 minutes133$23.5K$176.842.59x
93018Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician interpretation and report1.2K$13.6K$11.204.46x
93312Insertion of probe in esophagus for heart ultrasound examination including interpretation and report148$13.0K$87.783.94x

Markup Analysis

Charge-to-Payment Ratio

3.74x

This provider submits charges 3.74 times higher than what Medicare actually pays.

What This Means

A markup ratio of 3.74x means for every $100 Medicare pays, this provider initially charges $374. This is higher than the national average.

Location

Crystal Lake, IL

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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