Medicare Enrolled
Dr. Ricardo Cardona Guarache, M.D.
Internal Medicine · Everett, WA
Practice pattern: Electrophysiology & Remote
— Practice combining electrophysiology and remote services
Research-focused
Very High
DATA COVERAGE
Data in 4 of 4 federal sources
Measures public federal data availability — not provider quality
Informational, not a quality rating.
This page presents federal public records about Dr. Cardona Guarache from CMS (NPPES, Open Payments, Medicare Provider Utilization, PECOS). It is not medical advice, an endorsement, or a judgment of clinical quality. Always consult the provider directly and a licensed clinician for medical decisions. Read methodology →
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What this data tells you about Dr. Cardona Guarache
Dr. Ricardo Cardona Guarache is an internal medicine specialist in Everett, WA, with 17 years of NPI registration. Based on federal Medicare data, Dr. Cardona Guarache performed 2,607 Medicare services across 2,021 unique beneficiaries.
Between the years covered by Open Payments, Dr. Cardona Guarache received a total of $16,589 from 8 pharmaceutical and/or device companies across 93 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common in internal medicine. The majority of payments are classified as research and scientific activities (grants and research funding). Patients may wish to discuss these relationships with their provider.
The Data Coverage level for Dr. Cardona Guarache is Very High — reflecting how much public federal data is available about this provider. Patients are encouraged to use this data as one of several factors when choosing a healthcare provider.
✓ 17 years in practice
▲ Top 4% volume in WA
$16,589 industry payments
Medicare Practice Summary
Medicare Utilization ↗2,607
Medicare services
Top 4% in WA for internal medicine
2,021
Unique beneficiaries
$66
Avg. Medicare payment
Medicare patients only (65+ / disabled) · How to read this →
~153 Medicare services per year of practice
Top procedures by volume
Ranked by number of services performed for Medicare patients. Avg. submitted charge is what the provider billed; avg. Medicare payment is what CMS paid.
| Procedure | Volume | Avg. paid | Avg. submitted |
|---|---|---|---|
| Remote pacemaker/defibrillator monitoring, 90 days Remote evaluation of a pacemaker or implantable defibrillator system within 90 days of the last check. |
455 | $16 | $78 |
| Remote pacemaker monitoring, 90 days Remote assessment of a pacemaker system, including single, dual, multiple lead, or leadless devices, performed up to 90 days apart. |
325 | $21 | $87 |
| Office visit, established patient (30-39 min) A follow-up office visit for an existing patient lasting between 30 and 39 minutes. The visit involves medical evaluation and management of the patient's condition. |
235 | $89 | $309 |
| Remote evaluation of implantable defibrillator system Remote assessment of a single, dual, or multiple lead implantable defibrillator system within 90 days of the previous evaluation. |
123 | $26 | $166 |
| Pacemaker system evaluation Assessment of a pacemaker device, including single, dual, multiple lead, or leadless systems. |
119 | $42 | $145 |
| Prothrombin time test (blood clotting) A laboratory test that measures how long it takes for blood to clot. This procedure evaluates the body's coagulation process. |
104 | $4 | $9 |
| Office visit, established patient, complex (40-54 min) An office or outpatient visit for an existing patient lasting between 40 and 54 minutes. This level of service is determined by the total time spent on the date of the encounter. |
103 | $141 | $431 |
| Remote monitoring of implantable heart device, up to 30 days Remote evaluation of an implanted heart or blood vessel monitoring system over a period of up to 30 days. |
97 | $16 | $75 |
| EKG interpretation and report A standard electrocardiogram test that records the heart's electrical activity using at least 12 leads. The service includes a professional interpretation of the results and a written report. |
96 | $6 | $23 |
| Blood draw (venipuncture) Insertion of a needle into a vein to collect a blood sample. |
90 | $8 | $15 |
| Basic metabolic blood panel A blood test that measures a group of basic chemicals, including total calcium levels. |
83 | $8 | $18 |
| Echocardiogram, transthoracic An ultrasound of the heart that uses color to show blood flow, rate, direction, and valve function. |
79 | $139 | $608 |
| Complete blood count (CBC) with differential An automated laboratory test that measures the levels of red blood cells, white blood cells, and platelets in the blood, including a breakdown of the different types of white blood cells. |
71 | $7 | $18 |
| Heart rhythm stimulator programming after drug infusion Adjustment of a heart rhythm stimulation device following a drug infusion. This procedure involves reprogramming the device settings to ensure proper function after the medication has been administered. |
49 | $65 | $445 |
| Pacemaker programming, dual lead system Adjustment and configuration of a dual-lead pacemaker device to ensure proper operation and settings. |
45 | $64 | $209 |
| Implantable defibrillator system check A check of the implanted defibrillator device to ensure it is functioning correctly. This evaluation covers single, dual, or multiple lead systems. |
45 | $56 | $192 |
| Technetium Tc-99m sestamibi diagnostic injection A diagnostic injection of technetium Tc-99m sestamibi used for imaging studies. |
41 | $34 | $670 |
| New patient office visit (45-59 min) An initial office visit for a new patient lasting between 45 and 59 minutes. This code covers the total time spent by the physician or qualified healthcare professional on the date of the encounter. |
36 | $115 | $450 |
| New patient office visit, complex (60-74 min) | 35 | $157 | $568 |
| External EKG monitoring, 8-15 days Continuous external electrocardiogram recording and review over a period of 8 to 15 days to monitor heart rhythm. |
34 | $20 | $73 |
| Remote cardiac rhythm monitor evaluation, up to 30 days Review and analysis of data from a remote cardiac rhythm monitoring system over a period of up to 30 days. |
30 | $19 | $76 |
| Nuclear stress test of heart muscle A nuclear medicine imaging test that evaluates blood flow to the heart muscle at rest and during stress using a special camera. |
29 | $347 | $1,400 |
| Routine 12-lead electrocardiogram (ECG) A test that records the electrical activity of the heart using at least 12 leads to produce a tracing. |
27 | $4 | $25 |
| Pacemaker insertion with heart chamber electrodes A surgical procedure to implant a pacemaker device and place electrodes into the upper and lower chambers of the heart to regulate heart rhythm. |
25 | $401 | $1,456 |
| Atrial fibrillation ablation with pulmonary vein isolation A procedure to treat atrial fibrillation by mapping the heart's electrical activity and destroying tissue causing irregular contractions. This is done by isolating the pulmonary veins using catheter-based destruction. |
25 | $725 | $3,143 |
| Initial hospital admission, high complexity Initial hospital inpatient or observation care for a new patient involving high-level medical decision making, with at least 75 minutes total time on the date of the encounter. |
25 | $130 | $550 |
| Catheter ablation for abnormal heart rhythm A procedure where catheters are inserted to destroy tissue causing irregular heartbeats. |
24 | $238 | $1,194 |
| Radiofrequency ablation for supraventricular tachycardia A procedure to locate and destroy abnormal heart tissue in the upper chambers of the heart that causes a rapid heart rate. |
22 | $627 | $2,343 |
| Critical care, first 30-74 min Emergency medical care for a critically ill or injured patient lasting between 30 and 74 minutes. This service involves direct patient care and medical decision making to stabilize the patient. |
21 | $165 | $762 |
| Hospital follow-up visit, high complexity Subsequent hospital inpatient or observation care for an existing patient involving high-level medical decision making, with at least 50 minutes total time on the date of the encounter. |
19 | $95 | $284 |
| Sedation by physician, initial 15 minutes Administration of a drug to induce depression of consciousness by the physician performing a procedure. This code covers the initial 15 minutes of sedation for patients aged 5 years or older. |
17 | $10 | $34 |
| Insertion of implantable defibrillator system A surgical procedure to place an implantable cardioverter-defibrillator (ICD) device into the body. The device is connected to the heart to monitor heart rhythm and deliver shocks if dangerous arrhythmias occur. |
14 | $721 | $2,563 |
| Continuous external EKG monitoring, 8-15 days This procedure involves recording heart rhythm continuously using an external EKG device over a period of 8 to 15 days. |
14 | $9 | $42 |
| Echocardiogram with color Doppler An ultrasound of the heart that uses color imaging to visualize blood flow, measure flow rate, and assess valve function. |
14 | $2 | $9 |
| External shock to heart to regulate heart beat A procedure that delivers an electric shock to the heart from outside the body to restore a normal heart rhythm. |
12 | $87 | $506 |
| Programming of multiple lead implantable defibrillator system Adjustment and testing of the settings for an implanted heart device with multiple leads to ensure proper function. |
12 | $82 | $286 |
| Follow-up ultrasound of heart blood flow, valves and chambers An ultrasound exam that follows up on the heart's blood flow, valves, and chambers. It uses sound waves to create images of the heart's structure and function. |
12 | $6 | $20 |
How to read this data: This reflects Medicare patients only (typically 65+). Payment amounts are what Medicare paid the provider, not your out-of-pocket cost. A higher procedure volume generally indicates more experience with that procedure.
52.7% high complexity
3.2% medium
44.1% routine
Industry Payment Transparency
Open Payments through 2024 ↗$16,589
Total received (2018-2024)
Avg $2,765/year across 6 years
Top 5% in WA for internal medicine
A higher payment rank reflects disclosed industry relationships (consulting, research, speaking) common among subspecialists — not wrongdoing.
8
Companies
93
Individual payments
All payments are legal and publicly reported · Not evidence of wrongdoing · How to interpret →
Payment profile
Industry payments classified by relationship type. Not all payments are equal — research and consulting reflect different relationships than speaking programs or meals.
Scientific / Research
Research funding and grants
$9,470 (57.1%)
Meals & Travel
Food, beverages, travel, and lodging — typically low-value
$6,454 (38.9%)
Speaking / Promotional
Speaker programs, honoraria, and industry-sponsored educational events
$665 (4.0%)
Payment trend by year
Annual totals from pharmaceutical and medical device companies.
2024
$99
2022
$75
2021
$806
2020
$26
2019
$2,599
2018
$12,984
Payments by company (2024)
Consulting
Speaking
Meals & Travel
Research
Abbott Laboratories
$48
Janssen Pharmaceuticals, Inc
$26
Boston Scientific Corporation
$25
Top 3 companies account for 100.0% of 2024 payments
All-time payments by company (2018-2024) ›
Medtronic Vascular, Inc.
$11,288
Medical Device Business Services, Inc.
$2,236
Abbott Laboratories
$1,448
Medtronic, Inc.
$806
Boston Scientific Corporation
$540
Biosense Webster, Inc.
$158
ZOLL Services LLC (A/K/A ZOLL LifeCor Corp)
$87
Janssen Pharmaceuticals, Inc
$26
Top 3 companies account for 90.3% of all-time payments
Associated products mentioned in payments ›
AVEIR · Amplia MRI · Arctic Front · Azure · CONFIRM RX · CRT Leads · Cardiovascular- Research only · CareLink · CareLink Express · Carto 3 System · CartoSound · Claria MRI · EnSite Velocity System Expansion Modules · Ensite Cardiac Mapping System · Evera · Freezor · GENERAL THERAPIES · GENERAL THERAPIES · LifeVest · Micra · Quadra Assura CRT Defibrillator · RESONATE · SQRX PULSE GENERATOR · SelectSecure · WATCHMAN FLX · XARELTO
Should you be concerned? Payments from pharmaceutical and device companies are legal and common — 57% of U.S. physicians receive at least one. They often reflect legitimate consulting, research, or education. What matters is whether a recommended drug or device appears in your doctor's payment records. If so, consider asking your doctor about it. How to interpret this data →
The majority of payments (57%) are classified as scientific/research, suggesting involvement in clinical studies, grants, or innovation-related work. Total industry engagement is in the top 5% for internal medicine in WA.
Geographic Context
Internal medicine physicians within 10 mi
933
Per 100K population
111.8
County median income
$107,982
Nearest hospital
PROVIDENCE REGIONAL MEDICAL CENTER EVERETT
0.0 mi
0.0 mi
Data Sources
| Provider Registry | ✓ NPPES | Weekly updates |
| Medicare Enrollment | ✓ PECOS | Monthly updates |
| Practice Data | ✓ Medicare Util. | Annual (CY lag) |
| Industry Payments | ✓ Open Payments | CY 2024 |
| Disciplinary History | — Not public | N/A |
This provider has data in 4 of 4 available federal datasets, with a Data Coverage level of Very High. This reflects how much public data is available about a provider. How we calculate this →
Summary
Dr. Cardona Guarache is an electrophysiology & remote specialist, with above-average Medicare volume (top 4% in WA), with research-focused industry engagement in the top 5% of WA peers, with 17 years of NPI registration.
This summary is auto-generated from federal data, describing data availability and patterns. Read our methodology →
Frequently Asked Questions
Is Dr. Cardona Guarache experienced with remote pacemaker/defibrillator monitoring, 90 days?
Based on Medicare claims data, Dr. Cardona Guarache performed 455 remote pacemaker/defibrillator monitoring, 90 days services. Research suggests that higher procedure volume is often associated with better outcomes, particularly for complex procedures. Note that Medicare data only captures patients aged 65 and older, so the total practice volume across all patients is likely higher.
Does Dr. Cardona Guarache receive payments from pharmaceutical companies?
Yes. Dr. Cardona Guarache received a total of $16,589 from 8 companies across 93 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common among physicians — 57% of all U.S. physicians receive at least one industry payment. Patients may wish to ask their doctor about these relationships, especially if a recommended drug or device appears in the payment records.
How do Dr. Cardona Guarache's costs compare to other internal medicine physicians in Everett?
Dr. Cardona Guarache's average Medicare payment per service is $66. Note that these figures represent what Medicare pays, not your out-of-pocket cost, which depends on your specific insurance plan and deductible. Procedure-level data above shows both what was submitted and what Medicare paid for each service type.
What does Data Coverage mean?
Data Coverage (currently Very High for Dr. Cardona Guarache) measures how much public federal data is available about a provider. It is not a quality rating. A "Very High" or "High" level means the provider has data across multiple federal sources (NPPES, PECOS, Medicare Utilization, Open Payments), indicating a long track record of practice, Medicare participation, and industry disclosure. A "Low" or "Moderate" level may simply mean the provider is newer, does not see Medicare patients, or has not received any industry payments — none of which are inherently negative. Read our full methodology →
Is this data up to date?
Each data source has its own update cycle. Provider registry data (NPPES) is updated weekly. Medicare enrollment (PECOS) is updated monthly. Medicare practice data has a ~2 year lag — the most recent available is typically 2 years prior. Industry payment data (Open Payments) is published annually, usually in June, covering the prior calendar year. We display the data date prominently on each section so you always know how current it is. See our data freshness policy →
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About this page
All data on this page is sourced verbatim from public federal records published by the U.S. Centers for Medicare & Medicaid Services (CMS): NPPES ↗, Open Payments ↗, Medicare Provider Utilization ↗, and PECOS. Publication is mandated by the Physician Payments Sunshine Act (§6002 ACA, 42 U.S.C. §1320a-7h) and the Freedom of Information Act.
This page is not medical advice, an endorsement, a recommendation, or a quality rating. Data Coverage reflects data completeness — how much federal information exists for this provider — not clinical performance, patient outcomes, or quality of care. Always verify information directly with the provider and consult a licensed clinician before making medical decisions.
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