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4 million in 2012 to $56.7 million in 2015. At the beneficiary level, remote interrogations increased for pacemakers from 0.6/year to 0.9/year, and for ICDs from 1.3/year to 1.4/year, whereas in-office interrogations decreased (2.8/year to 2.7/year and 3.0/year to 2.9/year, respectively). Beneficiary-level analysis found increased expenditures on remote interrogation offset by decreases in in-office expenditures, with total annual spending decreasing by $2 and $5 per beneficiary respectively. Conclusions Remote monitoring utilization in