This provider's $6.1M in total Medicare payments ranks in the 98th 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.
Notable: Payments increased 8154% in 2023
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 | $268.07 | $113.18 | 2.37x | $154.89 | $609.3K | 7.7K | 5.2K |
| 2015 | $250.88 | $110.73 | 2.27x | $140.15 | $695.7K | 8.0K | 5.6K |
| 2016 | $238.80 | $102.02 | 2.34x | $136.78 | $672.7K | 7.5K | 5.7K |
| 2017 | $262.84 | $103.52 | 2.54x | $159.32 | $694.2K | 7.1K | 5.5K |
| 2018 | $735.49 | $170.10 | 4.32x | $565.39 | $855.2K | 7.4K | 5.0K |
| 2019 | $756.15 | $174.95 | 4.32x | $581.20 | $975.3K | 7.9K | 5.5K |
| 2020 | $854.47 | $208.91 | 4.09x | $645.56 | $838.7K | 6.5K | 4.2K |
| 2021 | $877.17 | $213.02 | 4.12x | $664.15 | $395.2K | 3.2K | 2.4K |
| 2022 | $147.50 | $62.62 | 2.36x | $84.88 | $4.6K | 81 | 50 |
| 2023 | $1.0K | $289.01 | 3.60x | $750.99 | $380.8K | 1.0K | 1.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 12.1K | $967.5K | $79.71 | 2.32x |
| 78492 | Nuclear medicine study heart muscle at rest and/or stress multiple studies | 646 | $760.9K | $1.2K | 4.50x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 4.9K | $743.2K | $151.48 | 4.52x |
| 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 1.9K | $706.2K | $381.53 | 2.37x |
| 95810 | Sleep monitoring of patient (6 years or older) in sleep lab | 1.0K | $506.6K | $484.28 | 2.96x |
| 95811 | Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube | 969 | $491.7K | $507.44 | 3.03x |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 1.9K | $193.9K | $104.83 | 2.52x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 5.2K | $167.9K | $32.14 | 3.27x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.7K | $151.1K | $55.08 | 2.52x |
| 93015 | Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report | 2.7K | $144.8K | $53.28 | 4.13x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.2K | $140.3K | $119.08 | 2.36x |
| 93229 | Heart rhythm tracing, computer analysis, physician prescribed transmission of patient-triggered events greater than 24-hour EKG up to 30 days | 244 | $138.6K | $568.11 | 7.92x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.2K | $135.7K | $110.72 | 3.31x |
| A9526 | Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries | 509 | $115.8K | $227.50 | 3.05x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 883 | $110.9K | $125.55 | 3.32x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 6.5K | $79.0K | $12.24 | 4.29x |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | 132 | $55.1K | $417.60 | 1.92x |
| J2785 | Injection, regadenoson, 0.1 mg | 1.2K | $54.6K | $44.10 | 1.95x |
| 93925 | Ultrasound study of arteries and arterial grafts of both legs | 236 | $42.0K | $178.14 | 2.40x |
| 93970 | Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers | 262 | $37.7K | $143.79 | 2.90x |
This provider submits charges 3.31 times higher than what Medicare actually pays.
A markup ratio of 3.31x means for every $100 Medicare pays, this provider initially charges $331. 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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