Statistical flag only — not an accusation of fraud
⚠️ This provider averages 212 services per working day — physically unusual for an individual practitioner
Based on 530.3K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $9.7M in total Medicare payments ranks in the 99th percentile of Osteopathic Manipulative Medicine providers nationally.
Averaging 212 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 1587% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 66/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1197% 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 | $141.26 | $51.94 | 2.72x | $89.32 | $329.4K | 6.3K | 30 |
| 2015 | $154.60 | $58.06 | 2.66x | $96.54 | $370.1K | 6.4K | 34 |
| 2016 | $156.32 | $59.37 | 2.63x | $96.95 | $455.9K | 7.7K | 37 |
| 2017 | $125.44 | $48.67 | 2.58x | $76.77 | $451.7K | 9.3K | 42 |
| 2018 | $121.78 | $45.33 | 2.69x | $76.45 | $591.2K | 13.0K | 39 |
| 2019 | $114.25 | $43.57 | 2.62x | $70.68 | $582.1K | 13.4K | 36 |
| 2020 | $148.20 | $56.26 | 2.63x | $91.94 | $430.3K | 7.6K | 33 |
| 2021 | $159.28 | $61.78 | 2.58x | $97.50 | $498.7K | 8.1K | 37 |
| 2022 | $156.02 | $56.92 | 2.74x | $99.10 | $428.5K | 7.5K | 35 |
| 2023 | $13.96 | $12.32 | 1.13x | $1.64 | $5.6M | 451.0K | 33 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 444.1K | $5.2M | $11.76 | 1.02x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 20.8K | $1.3M | $61.06 | 2.61x |
| 98929 | Osteopathic manipulative treatment, 9-10 body regions | 11.7K | $799.5K | $68.53 | 2.63x |
| 98928 | Osteopathic manipulative treatment, 7-8 body regions | 7.0K | $408.7K | $58.48 | 2.52x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 1.9K | $231.2K | $123.64 | 2.84x |
| 76942 | Ultrasonic guidance for needle placement | 4.5K | $218.2K | $48.22 | 3.06x |
| 76881 | Complete ultrasound scan of joint | 2.4K | $181.6K | $75.85 | 2.94x |
| 20611 | Aspiration and/or injection of fluid large joint using ultrasound guidance | 1.9K | $141.8K | $75.15 | 2.84x |
| 64450 | Injection of anesthetic agent and/or steroid into other nerve or branch | 2.1K | $130.4K | $63.11 | 2.81x |
| 20610 | Aspiration and/or injection of fluid from large joint | 1.6K | $83.8K | $51.10 | 3.06x |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 652 | $78.2K | $119.93 | 2.51x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 774 | $72.4K | $93.57 | 2.58x |
| 27096 | Injection procedure into sacroiliac joint for anesthetic or steroid | 497 | $71.5K | $143.85 | 3.02x |
| 64445 | Injection of anesthetic agent and/or steroid into lower back and leg nerve (sciatic nerve) | 621 | $69.0K | $111.13 | 2.63x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 312 | $54.1K | $173.43 | 1.24x |
| 20550 | Injection into tendon or ligament | 1.1K | $47.4K | $43.23 | 3.36x |
| 98927 | Osteopathic manipulative treatment, 5-6 body regions | 934 | $44.7K | $47.85 | 2.55x |
| 20926 | Tissue graft | 121 | $41.8K | $345.76 | 2.60x |
| J7320 | Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg | 5.5K | $41.4K | $7.58 | 2.04x |
| J7323 | Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose | 333 | $39.0K | $117.19 | 1.58x |
This provider submits charges 1.78 times higher than what Medicare actually pays.
A markup ratio of 1.78x means for every $100 Medicare pays, this provider initially charges $178. This is lower than the national average.
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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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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