This provider's $5.7M in total Medicare payments ranks in the 98th percentile of Cardiology providers nationally.
Medicare payments to this provider grew 151% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 159% in 2020
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 | $234.35 | $88.46 | 2.65x | $145.89 | $444.8K | 4.4K | 3.4K |
| 2015 | $265.32 | $104.36 | 2.54x | $160.96 | $432.4K | 4.3K | 3.3K |
| 2016 | $262.59 | $102.70 | 2.56x | $159.89 | $450.6K | 4.4K | 3.3K |
| 2017 | $226.13 | $83.93 | 2.69x | $142.20 | $185.7K | 3.1K | 2.5K |
| 2018 | $239.45 | $90.45 | 2.65x | $149.00 | $261.1K | 4.2K | 3.0K |
| 2019 | $238.79 | $88.63 | 2.69x | $150.16 | $238.6K | 3.7K | 2.6K |
| 2020 | $339.21 | $163.15 | 2.08x | $176.06 | $618.2K | 3.9K | 2.9K |
| 2021 | $401.82 | $186.51 | 2.15x | $215.31 | $1.2M | 6.5K | 4.5K |
| 2022 | $439.33 | $202.52 | 2.17x | $236.81 | $688.7K | 4.8K | 3.2K |
| 2023 | $421.91 | $188.45 | 2.24x | $233.46 | $1.1M | 6.6K | 4.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 78431 | Multiple nuclear medicine studies of blood flow in heart muscle at rest and with stress, with concurrently acquired ct transmission scan | 787 | $1.6M | $2.1K | 1.55x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 11.5K | $1.0M | $88.84 | 2.17x |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | 1.1K | $813.5K | $713.59 | 1.28x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 4.5K | $648.5K | $145.73 | 7.03x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.8K | $234.0K | $132.89 | 2.05x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 849 | $143.2K | $168.66 | 2.08x |
| 93229 | Heart rhythm tracing, computer analysis, physician prescribed transmission of patient-triggered events greater than 24-hour EKG up to 30 days | 198 | $132.1K | $667.30 | 1.50x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 732 | $119.9K | $163.86 | 3.05x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 7.9K | $100.9K | $12.79 | 5.08x |
| 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 | 1.3K | $82.8K | $63.43 | 3.15x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 865 | $74.2K | $85.79 | 1.74x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 452 | $56.6K | $125.20 | 2.26x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with ekg monitoring, physician supervision, interpretation, and report | 902 | $54.2K | $60.04 | 5.00x |
| 99443 | Physician telephone patient service, 21-30 minutes of medical discussion | 578 | $50.2K | $86.86 | 1.72x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 282 | $47.9K | $169.98 | 2.14x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 772 | $46.3K | $59.99 | 1.83x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 110 | $43.1K | $391.93 | 3.83x |
| 93280 | Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report | 743 | $42.2K | $56.78 | 2.20x |
| J2785 | Injection, regadenoson, 0.1 mg | 910 | $39.5K | $43.43 | 1.27x |
| 93224 | Heart rhythm tracing, analysis, and interpretation of 48-hour EKG | 535 | $34.7K | $64.83 | 5.40x |
This provider submits charges 2.57 times higher than what Medicare actually pays.
A markup ratio of 2.57x means for every $100 Medicare pays, this provider initially charges $257. 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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