This provider's $3.5M in total Medicare payments ranks in the 97th 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 | $385.91 | $89.35 | 4.32x | $296.56 | $302.7K | 3.1K | 1.8K |
| 2015 | $407.93 | $98.26 | 4.15x | $309.67 | $347.4K | 3.3K | 2.0K |
| 2016 | $409.34 | $98.79 | 4.14x | $310.55 | $354.4K | 3.4K | 2.1K |
| 2017 | $409.15 | $97.76 | 4.19x | $311.39 | $392.9K | 3.8K | 2.1K |
| 2018 | $423.94 | $98.23 | 4.32x | $325.71 | $321.5K | 3.2K | 2.1K |
| 2019 | $479.26 | $100.86 | 4.75x | $378.40 | $347.9K | 3.4K | 2.1K |
| 2020 | $530.65 | $101.73 | 5.22x | $428.92 | $307.2K | 3.1K | 2.0K |
| 2021 | $565.20 | $115.41 | 4.90x | $449.79 | $406.6K | 3.6K | 2.2K |
| 2022 | $621.86 | $112.97 | 5.50x | $508.89 | $355.7K | 3.4K | 2.1K |
| 2023 | $747.90 | $124.05 | 6.03x | $623.85 | $347.9K | 3.1K | 1.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 7.1K | $943.2K | $133.33 | 3.76x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 5.7K | $527.0K | $93.14 | 3.00x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 2.6K | $513.3K | $198.03 | 3.83x |
| 93351 | Ultrasound examination and continuous monitoring of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report | 1.8K | $395.1K | $224.99 | 4.55x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 2.4K | $303.3K | $128.53 | 7.64x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 2.2K | $142.5K | $63.40 | 3.30x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 729 | $132.0K | $181.02 | 3.39x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 648 | $114.1K | $176.11 | 3.07x |
| 93320 | Doppler ultrasound study of heart blood flow, valves, and chambers | 1.9K | $87.9K | $47.39 | 6.24x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 920 | $77.4K | $84.17 | 3.92x |
| 99443 | Physician telephone patient service, 21-30 minutes of medical discussion | 548 | $58.4K | $106.55 | 3.57x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 3.9K | $53.7K | $13.94 | 5.92x |
| 93325 | Doppler ultrasound study of color-directed heart blood flow, rate, and valve function | 1.9K | $41.4K | $22.28 | 15.99x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 296 | $21.6K | $72.83 | 3.17x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 144 | $19.4K | $134.79 | 3.94x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 124 | $14.9K | $119.85 | 3.75x |
| 99441 | Physician telephone patient service, 5-10 minutes of medical discussion | 325 | $14.6K | $44.84 | 3.37x |
| 99292 | Critical care delivery critically ill or injured patient | 116 | $11.6K | $99.80 | 3.00x |
| 93312 | Insertion of probe in esophagus for heart ultrasound examination including interpretation and report | 110 | $10.7K | $97.03 | 6.12x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 16 | $957.92 | $59.87 | 5.01x |
This provider submits charges 4.27 times higher than what Medicare actually pays.
A markup ratio of 4.27x means for every $100 Medicare pays, this provider initially charges $427. 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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