Skip to main content
UniHealth

Doctor search

Sumit Sehgal, MD

Cardiovascular Disease (Cardiology) · Gilroy

NPI 1083956502

Medicare standing
Clear
Enrolled, allowed to bill and order, not excluded
Plans that list them
18
3 carriers
Offices
5

Offices

5 locations · County of Santa Clara · 1,000 clinicians in this group

Looking this up.

Hospitals listed: Santa Clara Valley Medical Center. That is not proof they admit you there this week.

Plans that list them

18 plans · 3 carriers

A missing listing does not mean out of network. Directories change, and a listing does not cover every office. Call Dr. Sehgal’s office at (408) 885-5000 to confirm they take your plan. Ask about the office you use, its medical group, referrals and appointments.

18 of 18 plans

Plans whose provider directory lists this clinician
Alignment Health BreathEasy (HMO C-SNP)Alignment Health PlanListedOct 3, 2026
Alignment Health Clarity (HMO C-SNP)Alignment Health PlanListedOct 3, 2026
Alignment Health Harmony (HMO)Alignment Health PlanListedOct 3, 2026
Alignment Health Heart & Diabetes (HMO C-SNP)Alignment Health PlanListedOct 3, 2026
Alignment Health Heart & Diabetes CalPlus (HMO C-SNP)Alignment Health PlanListedOct 3, 2026
Alignment Health Heart & Diabetes Care (HMO C-SNP)Alignment Health PlanListedSep 28, 2026
Alignment Health Heart & Diabetes Choice (HMO C-SNP)Alignment Health PlanListedSep 28, 2026
Alignment Health Honor+ Plan (HMO)Alignment Health PlanListedOct 3, 2026
Alignment Health My Choice CalCare (HMO)Alignment Health PlanListedOct 3, 2026
Alignment Health Silicon (HMO C-SNP)Alignment Health PlanListedOct 3, 2026
Alignment Health smartHMO (HMO)Alignment Health PlanListedOct 3, 2026
Alignment Health the ONE (HMO)Alignment Health PlanListedOct 3, 2026
Anthem Full Dual Advantage Aligned (HMO D-SNP)Anthem Blue CrossListedOct 3, 2026
Anthem Medicare Advantage (HMO-POS)Anthem Blue CrossListedOct 3, 2026
SCAN Balance (HMO C-SNP)SCAN Health PlanListedOct 3, 2026
SCAN Classic (HMO)SCAN Health PlanListedOct 3, 2026
SCAN MyChoice (HMO)SCAN Health PlanListedOct 3, 2026
SCAN Strive (HMO C-SNP)SCAN Health PlanListedOct 3, 2026

Hospitals they work in

1 hospital

These rate the hospital, not this clinician. Most measures at most hospitals are no different from the national rate.

  • Santa Clara Valley Medical CenterSan Jose, CAAcute Care Hospital · Government - Local · Has an emergency department · Birthing-friendlyPart of Santa Clara Valley Health and Hospital System, which runs 3 hospitalsPatients rate it 3 of 5 · 70% would definitely recommend it
    Overall rating: 2 of 5 starsWorse than the national rate — SSI - Colon Surgery: 2.572, Oct 2024 – Sep 2025Better than the national rate — Central Line Associated Bloodstream Infection (ICU + select Wards): 0.563, Oct 2024 – Sep 2025Better than the national rate — Clostridium Difficile (C.Diff): 0.256, Oct 2024 – Sep 2025Better than the national rate — MRSA Bacteremia: 0.369, Oct 2024 – Sep 2025
See every measure and the patient survey for Santa Clara Valley Medical Center

Behind the star rating — Deaths: 2 better, 6 the same, 0 worse of 8 measures. Safety: 2 better, 5 the same, 1 worse of 8 measures. Readmissions: 0 better, 10 the same, 1 worse of 11 measures. The star rating is worked out from an earlier period than the measures below, so the two can disagree.

Every scored measure at Santa Clara Valley Medical Center
SSI - Colon SurgeryInfections2.572WorseOct 2024 – Sep 2025
Central Line Associated Bloodstream Infection (ICU + select Wards)Infections0.563BetterOct 2024 – Sep 2025
Clostridium Difficile (C.Diff)Infections0.256BetterOct 2024 – Sep 2025
MRSA BacteremiaInfections0.369BetterOct 2024 – Sep 2025
Abdominopelvic accidental puncture or laceration rateComplications and deaths1.25 (0.3 to 2.2) · 1,535 casesNo differentJul 2022 – Jun 2024
CMS Medicare PSI 90: Patient safety and adverse events compositeComplications and deaths1.07 (0.76 to 1.38)No differentJul 2022 – Jun 2024
Death rate among surgical inpatients with serious treatable complicationsComplications and deaths214.59 (167.38 to 261.8) · 108 casesNo differentJul 2022 – Jun 2024
Death rate for CABG surgery patientsComplications and deaths2.8 · 41 casesNoneJul 2022 – Jun 2025
Death rate for COPD patientsComplications and deaths6 · 141 casesNoneJul 2022 – Jun 2025
Death rate for heart attack patientsComplications and deaths10.2 · 124 casesNoneJul 2022 – Jun 2025
Death rate for heart failure patientsComplications and deaths8.3 · 501 casesNoneJul 2022 – Jun 2025
Death rate for pneumonia patientsComplications and deaths14.9 · 653 casesNoneJul 2022 – Jun 2025
Death rate for stroke patientsComplications and deaths10.1 · 348 casesNoneJul 2023 – Jun 2025
Hybrid Hospital-Wide All-Cause Risk Standardized Mortality RateComplications and deaths3 · 4,502 casesNoneJul 2024 – Jun 2025
Iatrogenic pneumothorax rateComplications and deaths0.24 (0.04 to 0.43) · 9,014 casesNo differentJul 2022 – Jun 2024
In-hospital fall-associated fracture rateComplications and deaths0.34 (0.15 to 0.52) · 9,216 casesNo differentJul 2022 – Jun 2024
Perioperative pulmonary embolism or deep vein thrombosis rateComplications and deaths4.54 (2.51 to 6.58) · 1,421 casesNo differentJul 2022 – Jun 2024
Postoperative acute kidney injury requiring dialysis rateComplications and deaths1.54 (0 to 3.2) · 288 casesNo differentJul 2022 – Jun 2024
Postoperative hemorrhage or hematoma rateComplications and deaths2.11 (0.66 to 3.56) · 1,446 casesNo differentJul 2022 – Jun 2024
Postoperative respiratory failure rateComplications and deaths11.61 (4.09 to 19.14) · 294 casesNo differentJul 2022 – Jun 2024
Postoperative sepsis rateComplications and deaths7.29 (3.39 to 11.2) · 299 casesNo differentJul 2022 – Jun 2024
Postoperative wound dehiscence rateComplications and deaths1.9 (0.45 to 3.36) · 333 casesNo differentJul 2022 – Jun 2024
Pressure ulcer rateComplications and deaths0.23 (0 to 0.78) · 7,538 casesNo differentJul 2022 – Jun 2024
Rate of complications for hip/knee replacement patientsComplications and deaths5.4 · 94 casesNoneApr 2023 – Mar 2025
Catheter Associated Urinary Tract Infections (ICU + select Wards)Infections0.735No differentOct 2024 – Sep 2025
SSI - Abdominal HysterectomyInfections2.573No differentOct 2024 – Sep 2025
Acute Myocardial Infarction (AMI) 30-Day Readmission RateUnplanned return visits14.6 · 185 casesNoneJul 2023 – Jun 2025
Heart failure (HF) 30-Day Readmission RateUnplanned return visits22.1 · 951 casesNoneJul 2023 – Jun 2025
Hospital return days for heart attack patientsUnplanned return visits56.3 · 128 casesNoneJul 2022 – Jun 2025
Hospital return days for heart failure patientsUnplanned return visits6.4 · 644 casesNoneJul 2022 – Jun 2025
Hospital return days for pneumonia patientsUnplanned return visits1.3 · 699 casesNoneJul 2022 – Jun 2025
Pneumonia (PN) 30-Day Readmission RateUnplanned return visits16.3 · 921 casesNoneJul 2023 – Jun 2025
Rate of emergency department (ED) visits for patients receiving outpatient chemotherapyUnplanned return visits5.7 (3.9 to 8.1) · 226 casesNo differentJan 2024 – Dec 2024
Rate of inpatient admissions for patients receiving outpatient chemotherapyUnplanned return visits12.6 (9.4 to 16.5) · 226 casesNo differentJan 2024 – Dec 2024
Rate of readmission after hip/knee replacementUnplanned return visits5.4 · 94 casesNoneJul 2023 – Jun 2025
Rate of readmission for CABGUnplanned return visits11.4 · 54 casesNoneJul 2023 – Jun 2025
Rate of readmission for chronic obstructive pulmonary disease (COPD) patientsUnplanned return visits20.3 · 242 casesNoneJul 2023 – Jun 2025
Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)Unplanned return visits13.2 (9.9 to 17.4) · 702 casesNo differentJan 2022 – Dec 2024
Ratio of unplanned hospital visits after hospital outpatient surgeryUnplanned return visits1 (0.7 to 1.4) · 195 casesNo differentJan 2024 – Dec 2024

What patients said (4,032 patients answered, 29% of those asked)

Patient survey stars by topic at Santa Clara Valley Medical Center
Cleanliness3
Nurse communication3
Doctor communication3
Communication about medicines3
Discharge information2
Overall hospital rating3
Quietness2
Recommend hospital4
Share of patients giving the best answer at Santa Clara Valley Medical Center
Room was "always" clean70%
Nurses "always" communicated well73%
Doctors "always" communicated well76%
Staff "always" explained57%
Yes, staff "did" give patients this information82%
Yes, staff "did" give patients information about help after discharge82%
Doctors "always" explained things so they could understand71%
Doctors "always" listened carefully74%
Doctors "always" treated them with courtesy and respect82%
Patients who gave a rating of "9" or "10" (high)67%
Staff "always" explained new medications71%
Nurses "always" explained things so they could understand71%
Nurses "always" listened carefully69%
Nurses "always" treated them with courtesy and respect80%
"Always" quiet at night43%
"YES", patients would definitely recommend the hospital70%
Staff "always" explained possible side effects44%
Yes, staff "did" give patients information about possible symptoms83%

Original Medicare doctor bills

$96,794

Medicare paid this office $96,794 for 763 people.

This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.

Largest Original Medicare bills
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function270$15,973$58
Nuclear medicine studies of heart muscle at rest and with stress and spect45$12,456$277
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function92$8,654$94
Technetium tc-99m sestamibi, diagnostic, per study dose45$8,454$95
Initial hospital care with moderate level of medical decision making at least 75 minutes44$6,974$152
See all 23 services
Every Original Medicare service billed
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function270$15,973$58
Nuclear medicine studies of heart muscle at rest and with stress and spect45$12,456$277
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function92$8,654$94
Technetium tc-99m sestamibi, diagnostic, per study dose45$8,454$95
Initial hospital care with moderate level of medical decision making at least 75 minutes44$6,974$152
Short return visit (20+ min)157$6,739$42
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes36$4,819$69
Return visit (30+ min)63$4,521$71
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 the57$2,979$23
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician51$2,228$44
New patient visit (45+ min)25$2,045$82
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes17$1,889$105
Injection, regadenoson, 0.1 mg37$1,640None
Initial hospital care with straightforward or low-level medical decision making at least 55 minutes15$1,631$109
Ultrasound of heart with probe in esophagus, with report20$1,615$81
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report128$852$6
Ultrasound of heart, follow-up13$567$44
Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequent59$406$3
Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days11$154$14
Ultrasound of heart blood flow, valves and chambers, follow-up12$142$12
Ultrasound of heart with color-depicted blood flow, rate and valve function12$132$11
Ultrasound of heart blood flow, valves and chambers, follow-up16$81$5
Ultrasound of heart with color-depicted blood flow, rate and valve function14$30$2

Who their Medicare patients are

763 Original Medicare patients in 2024. Average age 77 · Under 65 6% · 85 and older 22% · Women 50% · Also on Medicaid 23% · Health risk score 1.75. Above the middle of the specialty; the typical cardiology clinician is at 1.71.

Conditions among them: High blood pressure 75% · Coronary heart disease 48% · Atrial fibrillation 47% · Heart failure 44% · Diabetes 40% · Chronic kidney disease 39% · Depression 23% · COPD 22% · Cancer 16% · Stroke 14% · Dementia 12%.

The office billed $715,742, Medicare allowed $144,878 and paid $96,794; for 2,597 services of 44 kinds; $9,804 of it was for drugs given in the office and $86,990 for care.

Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.

Year by year

Original Medicare by year
20247632,597771.75$715,742$96,794
20231,5346,880771.34$1,207,409$319,926
20221,7866,309771.42$1,284,481$346,314
20211,9436,639771.47$1,360,052$418,945
20201,7995,617771.61$1,066,343$320,646
20191,0472,739771.63$466,353$149,434

Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.

See the services billed each year

2023: 35 services

Original Medicare services billed in 2023
Nuclear medicine studies of heart muscle at rest and with stress and spect161$51,137$318
Short return visit (20+ min)607$44,133$59
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function312$42,730$137
Return visit (30+ min)328$32,701$88
Technetium tc-99m sestamibi, diagnostic, per study dose161$30,968$96
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 the75$25,705$44
Injection, regadenoson, 0.1 mg119$17,647None
New patient visit (45+ min)130$14,445$111
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician183$8,323$45
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function122$6,346$52
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report441$4,466$9
Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequent75$3,451$6
Ultrasound of heart with probe in esophagus, with report39$3,357$80
Injection, perflutren lipid microspheres, per ml44$3,136$35
Ultrasound of heart, follow-up27$1,960$70
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes19$1,590$59
External shock to heart to regulate heart beat19$1,516$80
New patient visit (30+ min)20$1,454$73
Office for the evaluation and management of established patient that may not require presence of healthcare professional20$1,138$15
Electrocardiogram (ecg) 2-day continuous with review and report by health care professional19$927$49
Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days34$599$18
Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days88$539$6
Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days68$499$7
Ultrasound of heart blood flow, valves and chambers, follow-up27$496$18
Ultrasound of heart with color-depicted blood flow, rate and valve function27$461$16
Programming of dual lead pacemaker system13$413$32
Blood test, clotting time22$365$4
Electrocardiogram (ecg) 2-day continuous with review by health care professional26$347$13
Heart rhythm review and interpretation of continous external ekg over 8-15 days15$292$19
Evaluation of single, dual, or multiple lead implantable defibrillator system, remote up to 90 days20$291$15
Heart rhythm recording continous external ekg over more than 48 hours up to 7 days35$272$8
Ultrasound of heart blood flow, valves and chambers, follow-up39$223$5
Ultrasound of heart with color-depicted blood flow, rate and valve function39$98$2
Heart rhythm recording of continous external ekg over 8-15 days13$97$7
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only13$73$6

2022: 36 services

Original Medicare services billed in 2022
Nuclear medicine studies of heart muscle at rest and with stress and spect173$57,213$331
Return visit (30+ min)395$43,383$90
Short return visit (20+ min)535$42,021$63
Technetium tc-99m sestamibi, diagnostic, per study dose173$37,151$107
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function245$35,207$142
Injection, regadenoson, 0.1 mg122$21,615None
New patient visit (45+ min)183$20,291$111
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 the51$14,551$32
Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days393$11,265$20
Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days506$10,986$15
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician183$8,471$46
Evaluation of single, dual, or multiple lead implantable defibrillator system, remote up to 90 days118$4,523$26
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function83$4,257$51
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report398$4,120$9
Programming of dual lead pacemaker system50$3,189$58
Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequent51$2,619$6
Ultrasound of heart with probe in esophagus, with report25$2,064$83
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and tec27$1,507$33
Ultrasound of heart, follow-up19$1,413$71
Injection, perflutren lipid microspheres, per ml18$1,230$34
External shock to heart to regulate heart beat15$1,220$81
Electrocardiogram (ecg) 2-day continuous with review and report by health care professional24$1,154$48
Heart rhythm recording, analysis, report, review, and interpretation of continous external ekg over more than 48 hours up to 7 days11$1,142$104
Evaluation of cardiac rhythm monitor system, remote up to 30 days27$912$20
New patient visit (30+ min)11$833$76
Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional25$483$19
Office for the evaluation and management of established patient that may not require presence of healthcare professional18$479$17
Ultrasound of heart blood flow, valves and chambers, follow-up19$363$18
Ultrasound of heart with color-depicted blood flow, rate and valve function19$338$17
Electrocardiogram (ecg) 2-day continuous with report11$305$28
Electrocardiogram (ecg) up to 30 days continuous with symptom monitoring, transmission and review and report by health care professional14$284$19
Electrocardiogram (ecg) 2-day continuous with review by health care professional16$214$13
Blood test, clotting time25$173$4
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only31$156$5
Ultrasound of heart blood flow, valves and chambers, follow-up25$137$5
Ultrasound of heart with color-depicted blood flow, rate and valve function25$60$2

2021: 36 services

Original Medicare services billed in 2021
Nuclear medicine studies of heart muscle at rest and with stress and spect245$85,734$350
Return visit (30+ min)549$65,637$89
Technetium tc-99m sestamibi, diagnostic, per study dose253$53,885$108
Injection, regadenoson, 0.1 mg179$31,726None
Short return visit (20+ min)392$30,447$64
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function179$26,757$149
New patient visit (45+ min)236$25,803$109
Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days568$13,097$17
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician262$12,204$46
Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days417$11,897$21
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function124$6,671$54
Evaluation of single, dual, or multiple lead implantable defibrillator system, remote up to 90 days155$5,640$26
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and tec25$5,279$96
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report409$4,890$10
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes52$4,843$54
Programming of dual lead pacemaker system88$4,605$48
External shock to heart to regulate heart beat31$2,828$83
Initial hospital care with moderate level of medical decision making at least 75 minutes12$1,703$142
Ultrasound of heart with probe in esophagus, with report20$1,680$84
Ultrasound of heart, follow-up21$1,362$65
Electrocardiogram (ecg) 2-day continuous with review and report by health care professional21$1,104$53
Evaluation of cardiac rhythm monitor system, remote up to 30 days26$1,076$19
Programming of dual lead implantable defibrillator system16$1,013$63
Programming of multiple lead implantable defibrillator system13$925$71
Office for the evaluation and management of established patient that may not require presence of healthcare professional29$886$17
Electrocardiogram (ecg) up to 30 days continuous with symptom monitoring, transmission and review and report by health care professional41$830$19
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only118$798$6
Programming of single lead pacemaker system16$780$46
Ultrasound of heart blood flow, valves and chambers, follow-up18$320$18
Ultrasound of heart with color-depicted blood flow, rate and valve function18$299$17
Blood test, clotting time33$296$4
Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional12$277$20
Electrocardiogram (ecg) 2-day continuous with review by health care professional19$262$14
Electrocardiogram (ecg) 2-day continuous with review by health care professional16$233$15
Ultrasound of heart blood flow, valves and chambers, follow-up20$111$6
Ultrasound of heart with color-depicted blood flow, rate and valve function20$49$2

2020: 34 services

Original Medicare services billed in 2020
Nuclear medicine studies of heart muscle at rest and with stress and spect181$63,338$350
Return visit (30+ min)397$43,157$79
Technetium tc-99m sestamibi, diagnostic, per study dose182$39,257$108
Injection, regadenoson, 0.1 mg143$25,187None
Short return visit (20+ min)351$24,666$50
New patient visit (45+ min)179$18,996$106
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function122$17,474$143
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function182$10,803$57
Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days511$10,381$16
Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days380$9,961$20
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician195$9,273$47
Programming of dual lead pacemaker system100$5,589$51
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report339$5,150$11
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and tec30$4,859$99
Evaluation of single, dual, or multiple lead implantable defibrillator system, remote up to 90 days135$4,516$26
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes39$3,556$56
External shock to heart to regulate heart beat27$2,702$84
Electrocardiogram (ecg) 2-day continuous with review and report by health care professional38$2,319$61
Ultrasound of heart with probe in esophagus, with report20$1,899$86
Programming of dual lead implantable defibrillator system23$1,792$69
Evaluation of cardiac rhythm monitor system, remote up to 30 days28$924$21
Programming of multiple lead implantable defibrillator system11$837$70
Ultrasound of heart, follow-up11$739$67
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only100$651$6
New patient visit (30+ min)11$646$59
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only85$589$6
Programming of single lead pacemaker system11$493$45
Electrocardiogram (ecg) 2-day continuous with review by health care professional23$455$20
Electrocardiogram (ecg) up to 30 days continuous with symptom monitoring, transmission and review and report by health care professional26$437$17
Office for the evaluation and management of established patient that may not require presence of healthcare professional23$324$12
Electrocardiogram (ecg) 2-day continuous with report12$317$26
Blood test, clotting time30$178$4
Ultrasound of heart blood flow, valves and chambers, follow-up26$166$6
Ultrasound of heart with color-depicted blood flow, rate and valve function26$73$3

2019: 24 services

Original Medicare services billed in 2019
Nuclear medicine studies of heart muscle at rest and with stress and spect85$29,814$351
Technetium tc-99m sestamibi, diagnostic, per study dose86$18,367$107
Return visit (30+ min)156$14,293$81
Short return visit (20+ min)192$13,538$55
Injection, regadenoson, 0.1 mg69$12,126None
New patient visit (45+ min)97$11,351$117
Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days319$6,239$18
Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days238$5,885$23
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function98$5,521$56
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function38$5,224$137
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician93$4,332$47
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report220$3,178$12
Evaluation of single, dual, or multiple lead implantable defibrillator system, remote up to 90 days84$3,037$33
New patient visit (30+ min)31$2,322$75
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes21$1,809$55
Initial hospital care with moderate level of medical decision making at least 75 minutes11$1,676$152
Programming of dual lead pacemaker system29$1,506$47
Remote evaluations of implantable heart and blood vessel monitor or loop recorder system with technician analysis, review, and report, up to 30 days11$1,505$94
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only123$943$6
Electrocardiogram (ecg) 2-day continuous with review and report by health care professional12$720$60
Office for the evaluation and management of established patient that may not require presence of healthcare professional18$352$17
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only51$336$6
Evaluation of cardiac rhythm monitor system, remote up to 30 days11$303$19
Blood test, clotting time25$141$4

Medicaid work

$6,666 in 2024

Medicaid paid $6,666 for 341 billed services this clinician did in 2024, up to 84 people in a month for one service.

Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.

Largest Medicaid services in 2024
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography326$6,229
Short return visit (20+ min)15$437
Medicaid work by year
2024341284$6,666
2023219425$13,638
2022348626$14,973
2021870643$40,437
2020556656$22,067
2019168457$2,812
See the largest Medicaid services in earlier years

2023

Largest Medicaid services in 2023
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography75$8,876
Short return visit (20+ min)118$4,097
Return visit (30+ min)13$411
Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report13$255

2022

Largest Medicaid services in 2022
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography52$4,764
Short return visit (20+ min)117$3,422
New patient visit (45+ min)32$2,894
Return visit (30+ min)57$2,230
Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report76$1,423
Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, leadless pacemaker system, or implantable defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results14$240

2021

Largest Medicaid services in 2021
Return visit (30+ min)336$14,938
New patient visit (45+ min)123$11,160
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography40$5,729
Short return visit (20+ min)161$4,421
Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report177$3,779
Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, leadless pacemaker system, or implantable defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results33$410

2020

Largest Medicaid services in 2020
Return visit (30+ min)127$5,952
Short return visit (20+ min)162$5,823
New patient visit (45+ min)43$4,458
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography31$3,068
Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report132$2,306
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only61$459

2019

Largest Medicaid services in 2019
Short return visit (20+ min)29$1,097
Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report65$1,033
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only62$528
Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, leadless pacemaker system, or implantable defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results12$154

Drugs they prescribed that Part D paid

$415,929

Pharmacies billed $415,929 in 2024.

This is pharmacy cost, not the office bill, and not what patients paid.

Opioids were 0% of their Part D prescriptions (0 of 3,578) in 2024. At or below the middle of the specialty; the typical cardiology clinician is at 0%.

3,078 generic and 500 brand-name prescriptions · $415,929 in drug cost.

Part D prescriptions only. The opioid rate is opioid prescriptions as a share of all this clinician's Part D prescriptions; surgeons and pain specialists run higher than others, so it is shown against the same specialty.

Largest Part D drug costs
Eliquis280$235,746$842
Xarelto70$69,083$987
Entresto19$23,313$1,227
Brilinta24$11,222$468
Praluent16$7,936$496
See all 42 drugs
Every Part D drug this clinician prescribed
Eliquis280$235,746$842
Xarelto70$69,083$987
Entresto19$23,313$1,227
Brilinta24$11,222$468
Praluent16$7,936$496
Metoprolol407$5,902$15
Potassium Chloride148$2,409$16
Ranolazine Er19$2,220$117
Atorvastatin305$2,058$7
Ezetimibe47$1,455$31
Sotalol110$1,441$13
Valsartan84$1,299$15
Amiodarone77$1,232$16
Midodrine18$1,229$68
Diltiazem 24hr Er (Cd)80$1,186$15
Losartan141$954$7
Rosuvastatin106$937$9
Hydralazine70$917$13
Dofetilide14$906$65
Metoprolol144$777$5
Clopidogrel105$734$7
Verapamil Er32$702$22
Carvedilol132$660$5
Amlodipine Besylate139$624$4
Isosorbide Mononitrate Er59$604$10
Bumetanide27$574$21
Diltiazem 24hr Er16$538$34
Spironolactone112$537$5
Furosemide145$503$3
Lisinopril101$488$5
Torsemide36$414$11
Warfarin45$410$9
Flecainide Acetate13$365$28
Pravastatin21$334$16
Nitroglycerin29$272$9
Hydrochlorothiazide71$247$3
Simvastatin25$160$6
Telmisartan13$134$10
Atenolol20$129$6
Triamterene-Hydrochlorothiazid13$127$10
Doxazosin Mesylate11$120$11
Chlorthalidone11$80$7

Year by year

Part D prescribing by year
20243,5788680% (0)14%$415,929
20236,7951,1520% (0)10%$649,133
20226,6901,1560% (0)11%$582,383
20216,6781,1500% (0)13%$469,366
20205,2398360% (0)10%$280,189
20191,1383730% (0)10%$42,950
201743None0% (0)0%$431
201643None0% (0)None$918
201511NoneNone0%$56
201311NoneNone0%$98

Part D prescriptions only. A drug prescribed to fewer than 11 people in a year is hidden.

See the drugs prescribed each year

2023: 55 drugs

Part D drugs prescribed in 2023
Eliquis424$358,586$846
Xarelto80$89,218$1,115
Praluent49$30,539$623
Brilinta21$16,356$779
Entresto13$14,115$1,086
Metoprolol740$12,961$18
Potassium Chloride366$9,978$27
Atorvastatin662$7,601$11
Ezetimibe92$5,258$57
Bumetanide93$4,572$49
Ranolazine Er34$4,285$126
Dofetilide16$3,827$239
Amiodarone169$3,662$22
Valsartan140$3,585$26
Diltiazem 24hr Er (Cd)132$3,261$25
Losartan284$2,987$11
Rosuvastatin182$2,950$16
Clopidogrel165$2,739$17
Carvedilol324$2,389$7
Sotalol161$2,293$14
Hydralazine139$2,163$16
Warfarin135$1,837$14
Furosemide283$1,746$6
Flecainide Acetate30$1,724$57
Verapamil Er66$1,630$25
Metoprolol243$1,600$7
Spironolactone214$1,580$7
Amlodipine Besylate244$1,513$6
Bisoprolol27$1,458$54
Lisinopril212$1,400$7
Valsartan-Hydrochlorothiazide31$1,355$44
Clonidine11$1,342$122
Pravastatin71$1,126$16
Isosorbide Mononitrate Er99$1,121$11
Midodrine19$1,021$54
Nitroglycerin58$956$16
Propranolol24$861$36
Simvastatin82$728$9
Diltiazem 24hr Er21$679$32
Hydrochlorothiazide135$587$4
Losartan-Hydrochlorothiazide19$578$30
Torsemide33$547$17
Potassium Citrate Er12$449$37
Fenofibrate29$446$15
Enalapril Maleate21$432$21
Doxazosin Mesylate24$424$18
Olmesartan Medoxomil13$405$31
Triamterene-Hydrochlorothiazid39$384$10
Telmisartan17$241$14
Atenolol28$193$7
Clonidine12$185$15
Verapamil21$180$9
Chlorthalidone21$158$8
Benazepril13$132$10
Irbesartan23$109$5

2022: 51 drugs

Part D drugs prescribed in 2022
Eliquis457$365,695$800
Xarelto42$39,217$934
Praluent32$21,615$675
Entresto12$16,099$1,342
Brilinta21$13,041$621
Metoprolol757$12,748$17
Potassium Chloride324$10,927$34
Repatha Sureclick13$8,207$631
Ezetimibe99$7,132$72
Atorvastatin661$6,080$9
Amiodarone157$5,323$34
Bumetanide108$5,059$47
Valsartan125$4,136$33
Diltiazem 24hr Er (Cd)131$3,702$28
Losartan315$2,914$9
Clopidogrel161$2,621$16
Carvedilol346$2,516$7
Sotalol159$2,470$16
Ranolazine Er32$2,203$69
Rosuvastatin129$1,741$13
Flecainide Acetate28$1,736$62
Hydralazine110$1,474$13
Spironolactone203$1,413$7
Metoprolol265$1,372$5
Furosemide322$1,317$4
Isosorbide Mononitrate Er119$1,299$11
Amlodipine Besylate287$1,105$4
Lisinopril217$1,086$5
Warfarin142$1,062$7
Diltiazem 24hr Er29$912$31
Pravastatin58$890$15
Nitroglycerin48$877$18
Valsartan-Hydrochlorothiazide37$809$22
Verapamil Er43$721$17
Simvastatin91$662$7
Propranolol23$651$28
Bisoprolol19$617$32
Hydrochlorothiazide130$559$4
Olmesartan Medoxomil11$530$48
Fenofibrate19$450$24
Doxazosin Mesylate14$364$26
Enalapril Maleate14$350$25
Torsemide11$252$23
Fenofibrate13$247$19
Irbesartan16$193$12
Losartan-Hydrochlorothiazide13$160$12
Triamterene-Hydrochlorothiazid25$153$6
Chlorthalidone11$145$13
Atenolol28$127$5
Clonidine11$124$11
Verapamil13$100$8

2021: 49 drugs

Part D drugs prescribed in 2021
Eliquis420$284,105$676
Xarelto64$39,271$614
Entresto21$19,021$906
Praluent33$16,635$504
Metoprolol651$11,319$17
Bumetanide93$6,579$71
Atorvastatin623$6,455$10
Ezetimibe111$5,556$50
Potassium Chloride258$4,988$19
Losartan427$3,879$9
Ranolazine Er61$3,707$61
Diltiazem 24hr Er (Cd)146$3,676$25
Rosuvastatin127$3,333$26
Amiodarone129$3,209$25
Carvedilol427$2,982$7
Clopidogrel209$2,192$10
Sotalol148$1,999$14
Metoprolol350$1,701$5
Spironolactone240$1,665$7
Flecainide Acetate35$1,555$44
Hydralazine107$1,300$12
Valsartan29$1,294$45
Isosorbide Mononitrate Er134$1,221$9
Furosemide374$1,197$3
Lisinopril211$1,188$6
Diltiazem 24hr Er43$1,000$23
Midodrine20$960$48
Warfarin107$942$9
Hydrochlorothiazide180$856$5
Amlodipine Besylate226$825$4
Fenofibrate28$663$24
Pravastatin51$654$13
Propranolol28$613$22
Enalapril Maleate17$511$30
Cartia Xt11$467$42
Nitroglycerin33$435$13
Simvastatin65$413$6
Bisoprolol14$355$25
Digoxin11$342$31
Olmesartan Medoxomil14$312$22
Triamterene-Hydrochlorothiazid31$287$9
Atenolol22$279$13
Fenofibrate11$263$24
Diltiazem20$206$10
Irbesartan13$205$16
Pantoprazole19$181$10
Pacerone13$112$9
Benazepril12$108$9
Lisinopril-Hydrochlorothiazide12$28$2

2020: 48 drugs

Part D drugs prescribed in 2020
Eliquis232$136,691$589
Xarelto43$24,431$568
Praluent20$16,504$825
Entresto21$15,838$754
Pradaxa11$9,801$891
Metoprolol524$7,821$15
Potassium Chloride258$3,932$15
Atorvastatin399$3,790$9
Rosuvastatin183$3,492$19
Bumetanide84$3,087$37
Ezetimibe79$2,797$35
Diltiazem 24hr Er (Cd)123$2,516$20
Amiodarone71$2,229$31
Carvedilol376$2,084$6
Ranolazine Er30$2,004$67
Losartan268$1,801$7
Warfarin165$1,665$10
Hydralazine121$1,655$14
Clopidogrel189$1,328$7
Isosorbide Mononitrate Er118$1,226$10
Sotalol82$1,153$14
Lisinopril240$1,080$5
Metoprolol266$1,018$4
Pravastatin47$1,017$22
Midodrine18$989$55
Spironolactone208$982$5
Furosemide245$787$3
Valsartan19$632$33
Diltiazem 24hr Er28$625$22
Amlodipine Besylate149$600$4
Cartia Xt15$580$39
Enalapril Maleate25$529$21
Nitroglycerin37$502$14
Bisoprolol13$490$38
Hydrochlorothiazide93$457$5
Digoxin15$445$30
Valsartan-Hydrochlorothiazide11$440$40
Fludrocortisone Acetate18$390$22
Chlorthalidone21$346$16
Propafenone13$317$24
Atenolol33$206$6
Simvastatin43$199$5
Diltiazem16$187$12
Triamterene-Hydrochlorothiazid16$186$12
Trandolapril12$126$11
Pantoprazole13$91$7
Jantoven12$60$5
Lisinopril-Hydrochlorothiazide11$39$4

2019: 24 drugs

Part D drugs prescribed in 2019
Eliquis35$16,825$481
Rosuvastatin40$2,031$51
Bumetanide29$1,458$50
Potassium Chloride79$1,227$16
Metoprolol78$1,167$15
Atorvastatin100$954$10
Amiodarone12$691$58
Warfarin49$549$11
Chlorthalidone20$449$22
Hydralazine23$409$18
Nitroglycerin20$375$19
Carvedilol63$291$5
Ezetimibe12$284$24
Lisinopril74$276$4
Pravastatin18$254$14
Isosorbide Mononitrate Er21$251$12
Diltiazem 24hr Er (Cd)18$218$12
Clopidogrel38$217$6
Spironolactone31$206$7
Losartan48$203$4
Metoprolol82$199$2
Furosemide71$152$2
Amlodipine Besylate32$131$4
Simvastatin14$59$4

2017: 2 drugs

Part D drugs prescribed in 2017
Spironolactone14$106$8
Carvedilol11$66$6

Money from drug and device companies

$62 in 2025

Industry payments by year
202522None$62
202411None$21
202322None$25
202224None$55
202122None$25
2020410None$787
201956None$371

Paid work is consulting, speaking, honoraria and royalties, as opposed to meals and travel.

A payment is not proof that care is biased.

Payments by company
CleerlyCleerly Ischemia$42
1 payment
  • Meals for Cleerly Ischemia · 2025-10-22 · $42
HeartflowFfrct$20
1 payment
  • Meals for Ffrct · 2025-10-21 · $20
See all 2 published payments
Every published payment
CleerlyMeals · 2025-10-22Cleerly Ischemia$42
HeartflowMeals · 2025-10-21Ffrct$20
See earlier years (2024, 2023, 2022, 2021, 2020, 2019)

2024: $21

Payments by company in 2024
AmgenRepatha$21
1 payment
  • Meals for Repatha · 2024-02-22 · $21

2023: $25

Payments by company in 2023
E.R. Squibb & Sons L.L.C.Camzyos$20
1 payment
  • Meals for Camzyos · 2023-03-21 · $20
ZOLL Services LLC (A/K/A ZOLL LifeCor Corp)Lifevest$5
1 payment
  • Meals for Lifevest · 2023-10-11 · $5

2022: $55

Payments by company in 2022
Boston ScientificWatchman Access System$43
3 payments
  • Meals for Watchman Access System · 2022-11-29 · $12
  • Meals for Watchman Access System · 2022-06-13 · $16
  • Meals for Watchman Access System · 2022-03-02 · $15
Novartis PharmaceuticalsLeqvio$12
1 payment
  • Meals for Leqvio · 2022-10-19 · $12

2021: $25

Payments by company in 2021
Abbott LaboratoriesCardiomems Hf System$22
1 payment
  • Meals for Cardiomems Hf System · 2021-10-01 · $22
ZOLL Services LLC (A/K/A ZOLL LifeCor Corp)Lifevest$4
1 payment
  • Meals for Lifevest · 2021-02-05 · $4

2020: $787

Payments by company in 2020
BiotronikNone$755
7 payments
  • Travel · 2020-02-27 · $29
  • Meals · 2020-02-09 · $84
  • Travel · 2020-01-23 · $403
  • Meals · 2020-01-23 · $53
  • Meals · 2020-01-23 · $57
  • Meals · 2020-01-23 · $74
  • Meals · 2020-01-23 · $56
Boston ScientificWatchman$14
1 payment
  • Meals for Watchman · 2020-09-03 · $14
Novo NordiskNone$13
1 payment
  • Meals · 2020-03-11 · $13
ZOLL Services LLC (A/K/A ZOLL LifeCor Corp)Lifevest$4
1 payment
  • Meals for Lifevest · 2020-12-04 · $4

2019: $371

Payments by company in 2019
CVRxBarostim Neo System$125
1 payment
  • Meals for Barostim Neo System · 2019-06-07 · $125
ZOLL Services LLC (A/K/A ZOLL LifeCor Corp)Lifevest$81
2 payments
  • Meals for Lifevest · 2019-11-06 · $13
  • Meals for Lifevest · 2019-06-07 · $69
Abbott LaboratoriesCardiomems Hf System$69
1 payment
  • Meals for Cardiomems Hf System · 2019-07-09 · $69
Medtronic VascularHeartware Hvad$55
1 payment
  • Meals for Heartware Hvad · 2019-06-08 · $55
Terumo MedicalAngioseal$42
1 payment
  • Meals for Angioseal · 2019-01-24 · $42

Professional record

NPI
1083956502
Licence
IA MD-45758
Gender
Male
More record details
Sole proprietor
No
Taxonomy
Cardiology (207RC0000X); Student in a training program (390200000X)
Mailing address
Po Box 9170, Des Moines, IA, 50306
NPI first listed
2013-03-22
NPI last updated
2019-11-05

This is when the NPI record was last certified, not a medical board exam.