Statistical flag only — not an accusation of fraud
⚠️ This provider averages 836 services per working day — physically unusual for an individual practitioner
Based on 835.8K total services over 4 years (250 working days/year). Learn about impossible service volumes →
This provider's $9.9M in total Medicare payments ranks in the 99th percentile of Physical Therapist in Private Practice providers nationally.
Averaging 836 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 16333% from 2014 to 2023.
99% of their billing comes from a single procedure code (K1034 — Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count).
This provider has been statistically flagged with a risk score of 68/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 39656% 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 | $41.78 | $18.82 | 2.22x | $22.96 | $59.4K | 3.2K | 5 |
| 2015 | $40.84 | $18.33 | 2.23x | $22.51 | $36.2K | 2.0K | 3 |
| 2016 | $41.18 | $19.58 | 2.10x | $21.60 | $24.5K | 1.3K | 2 |
| 2023 | $12.00 | $11.76 | 1.02x | $0.24 | $9.8M | 829.4K | 1 |
| 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 | 829.4K | $9.8M | $11.76 | 1.02x |
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 4.2K | $79.6K | $18.92 | 2.11x |
| 97112 | Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 937 | $21.8K | $23.31 | 1.93x |
| 97140 | Manual (physical) therapy techniques to 1 or more regions, each 15 minutes | 635 | $11.0K | $17.37 | 2.59x |
| 97116 | Walking training to 1 or more areas, each 15 minutes | 207 | $3.4K | $16.50 | 2.73x |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | 374 | $2.9K | $7.75 | 4.52x |
| 97001 | Physical therapy evaluation | 23 | $1.3K | $57.68 | 1.99x |
This provider submits charges 1.03 times higher than what Medicare actually pays.
A markup ratio of 1.03x means for every $100 Medicare pays, this provider initially charges $103. This is lower than the national average.
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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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