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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Providers
  3. Thomas Howard
⚕️
MDIndividual

Thomas Howard, MD

NPI: 1437144714
Cary, NC
9 years of data
Sports Medicine
$7.8M
Total Payments
45.2K
Beneficiaries
126.8K
Services
2.29x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$7.8M
Specialty median$71.5K

📋 Key Findings

1Billed $7.8M over 9 years
22.29x markup ratio (above median)
399th percentile in Sports Medicine by payments
456 services/day — unusually high
5Payments surged 913% in 2017
61 procedure with >3x markup

This provider averages 56 services per working day

Based on 126.8K total services over 9 years (250 working days/year). Learn about impossible service volumes →

🔎 Data Analysis

This provider's $7.8M in total Medicare payments ranks in the 99th percentile of Sports Medicine providers nationally.

Averaging 56 services per working day raises questions about billing patterns.

Medicare payments to this provider grew 972% from 2014 to 2023.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

📈

Notable: Payments increased 913% in 2017

Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$187.78$46.874.01x$140.91$24.4K422282
2016$121.48$51.822.34x$69.66$187.5K3.8K2.1K
2017$135.43$50.302.69x$85.13$1.9M27.5K11.8K
2018$149.39$55.732.68x$93.66$1.9M28.4K10.4K
2019$140.73$58.432.41x$82.30$1.3M21.6K5.9K
2020$95.71$45.502.10x$50.21$751.9K14.1K4.5K
2021$109.17$53.802.03x$55.37$840.0K14.9K4.7K
2022$100.72$48.952.06x$51.77$636.9K11.4K3.5K
2023$103.66$48.112.15x$55.55$261.1K4.8K2.0K

Top Procedures (20)

77002Fluoroscopic guidance for insertion of needle
$2.0M
25.8K services$77.76/svc2.20x markup
20610Aspiration and/or injection of large joint or joint capsule
$1.1M
25.9K services$42.11/svc2.31x markup
J7321Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose
$1.1M
16.5K services$65.30/svc2.22x markup
27370Injection of contract for X-ray imaging of knee
$914.8K
6.0K services$152.19/svc2.27x markup
73580Radiological supervision and interpretation X-ray of knee joint
$534.4K
6.2K services$86.14/svc2.55x markup
J7324Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose
$444.7K
2.6K services$173.09/svc2.24x markup
76881Ultrasound of leg or arm
$444.0K
6.9K services$64.04/svc2.60x markup
99213Established patient office or other outpatient visit, typically 15 minutes
$237.6K
4.4K services$54.48/svc2.04x markup
99214Established patient office or other outpatient, visit typically 25 minutes
$232.7K
2.5K services$91.87/svc2.00x markup
73560X-ray of knee, 1 or 2 views
$120.1K
5.1K services$23.53/svc2.16x markup
99203New patient office or other outpatient visit, typically 30 minutes
$103.5K
1.4K services$75.31/svc2.45x markup
20611Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance
$95.5K
1.6K services$57.87/svc2.71x markup
99204New patient office or other outpatient visit, typically 45 minutes
$93.8K
762 services$123.16/svc2.04x markup
76882Ultrasound of arm or leg
$65.7K
1.7K services$38.76/svc2.05x markup
J7322Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg
$56.4K
2.6K services$21.92/svc1.90x markup
64450Injection of anesthetic agent, other peripheral nerve or branch⚠ 3.8x markup
$41.1K
1.1K services$37.73/svc3.80x markup
76942Ultrasonic guidance imaging supervision and interpretation for insertion of needle
$30.8K
667 services$46.24/svc2.61x markup
99215Established patient outpatient visit, total time 40-54 minutes
$29.2K
229 services$127.65/svc2.04x markup
J7320Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg
$28.9K
2.2K services$13.34/svc1.91x markup
J7332Hyaluronan or derivative, triluron, for intra-articular injection, 1 mg
$23.7K
1.5K services$16.00/svc1.94x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
77002Fluoroscopic guidance for insertion of needle25.8K$2.0M$77.762.20x
20610Aspiration and/or injection of large joint or joint capsule25.9K$1.1M$42.112.31x
J7321Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose16.5K$1.1M$65.302.22x
27370Injection of contract for X-ray imaging of knee6.0K$914.8K$152.192.27x
73580Radiological supervision and interpretation X-ray of knee joint6.2K$534.4K$86.142.55x
J7324Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose2.6K$444.7K$173.092.24x
76881Ultrasound of leg or arm6.9K$444.0K$64.042.60x
99213Established patient office or other outpatient visit, typically 15 minutes4.4K$237.6K$54.482.04x
99214Established patient office or other outpatient, visit typically 25 minutes2.5K$232.7K$91.872.00x
73560X-ray of knee, 1 or 2 views5.1K$120.1K$23.532.16x
99203New patient office or other outpatient visit, typically 30 minutes1.4K$103.5K$75.312.45x
20611Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance1.6K$95.5K$57.872.71x
99204New patient office or other outpatient visit, typically 45 minutes762$93.8K$123.162.04x
76882Ultrasound of arm or leg1.7K$65.7K$38.762.05x
J7322Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg2.6K$56.4K$21.921.90x
64450Injection of anesthetic agent, other peripheral nerve or branch1.1K$41.1K$37.733.80x
76942Ultrasonic guidance imaging supervision and interpretation for insertion of needle667$30.8K$46.242.61x
99215Established patient outpatient visit, total time 40-54 minutes229$29.2K$127.652.04x
J7320Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg2.2K$28.9K$13.341.91x
J7332Hyaluronan or derivative, triluron, for intra-articular injection, 1 mg1.5K$23.7K$16.001.94x

Markup Analysis

Charge-to-Payment Ratio

2.29x

This provider submits charges 2.29 times higher than what Medicare actually pays.

What This Means

A markup ratio of 2.29x means for every $100 Medicare pays, this provider initially charges $229. This is higher than the national average.

Location

Cary, NC

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

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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