Statistical flag only — not an accusation of fraud
This provider's $60.6M in total Medicare payments ranks in the 99th percentile of Independent Diagnostic Testing Facility (IDTF) providers nationally.
Their average markup ratio of 16.38x is significantly above the specialty median of 6.1x.
Medicare payments to this provider grew 297% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 79/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 115% in 2018
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 | $667.65 | $63.53 | 10.51x | $604.12 | $2.8M | 43.5K | 6 |
| 2015 | $475.58 | $43.58 | 10.91x | $432.00 | $1.3M | 29.9K | 6 |
| 2016 | $632.96 | $56.59 | 11.19x | $576.37 | $2.1M | 37.1K | 7 |
| 2017 | $756.11 | $64.12 | 11.79x | $691.99 | $2.8M | 43.0K | 7 |
| 2018 | $1.2K | $104.77 | 11.63x | $1.1K | $5.9M | 56.7K | 6 |
| 2019 | $1.5K | $121.66 | 12.41x | $1.4K | $8.4M | 69.3K | 7 |
| 2020 | $1.8K | $140.58 | 12.94x | $1.7K | $10.3M | 73.6K | 7 |
| 2021 | $2.2K | $66.72 | 32.49x | $2.1K | $6.9M | 102.7K | 6 |
| 2022 | $2.3K | $125.46 | 18.38x | $2.2K | $9.2M | 73.0K | 7 |
| 2023 | $2.6K | $146.26 | 17.80x | $2.5K | $11.0M | 75.0K | 10 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 0297T | Analysis and report of external ekg recording for more than 48 hours up to 21 days | 83.9K | $22.4M | $267.49 | 11.52x |
| 93243 | Heart rhythm analysis and report of continous external ekg over more than 48 hours up to 7 days | 103.5K | $16.2M | $156.43 | 22.37x |
| 93226 | Electrocardiogram (ecg) 2-day continuous with report | 329.3K | $10.7M | $32.41 | 14.99x |
| 93247 | Heart rhythm analysis and report of continous external ekg over 8-15 days | 42.5K | $7.2M | $168.64 | 22.53x |
| 93271 | Electrocardiogram (ecg) up to 30 days continuous with symptom monitoring and transmission and analysis | 24.4K | $3.4M | $138.74 | 11.81x |
| 93229 | Electrocardiogram (ecg) up to 30 days continuous with transmission of patient triggered events with review and report by health care professional | 543 | $337.5K | $621.61 | 12.38x |
| 93293 | Telephonic evaluation of single, dual, or multiple lead pacemaker heart rhythm strips up to 90 days | 3.0K | $116.5K | $38.65 | 5.91x |
| G0248 | Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: face-to | 1.0K | $92.9K | $90.83 | 6.63x |
| 95800 | Study of sleep patterns | 810 | $89.1K | $109.97 | 18.19x |
| 93242 | Heart rhythm recording continous external ekg over more than 48 hours up to 7 days | 4.6K | $36.3K | $7.96 | 31.39x |
| 93270 | Electrocardiogram (ecg) up to 30 days continuous with symptom monitoring | 6.0K | $35.2K | $5.87 | 39.40x |
| 93246 | Heart rhythm recording of continous external ekg over 8-15 days | 3.0K | $23.9K | $8.00 | 31.23x |
| 93225 | Electrocardiogram (ecg) 2-day continuous | 991 | $11.7K | $11.77 | 21.24x |
| 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 | 75 | $7.8K | $103.87 | 6.03x |
| 93296 | Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days | 42 | $782.40 | $18.63 | 12.88x |
This provider submits charges 16.38 times higher than what Medicare actually pays.
A markup ratio of 16.38x means for every $100 Medicare pays, this provider initially charges $1638. 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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