Statistical flag only — not an accusation of fraud
⚠️ This provider averages 349 services per working day — physically unusual for an individual practitioner
Based on 873.3K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $30.4M in total Medicare payments ranks in the 99th percentile of Neurology providers nationally.
Averaging 349 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 110% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 78/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 131% in 2022
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 | $92.93 | $22.75 | 4.08x | $70.18 | $2.1M | 93.0K | 39 |
| 2015 | $92.80 | $22.75 | 4.08x | $70.05 | $2.8M | 123.0K | 40 |
| 2016 | $96.30 | $25.46 | 3.78x | $70.84 | $3.7M | 145.8K | 47 |
| 2017 | $112.10 | $29.91 | 3.75x | $82.19 | $4.0M | 134.7K | 52 |
| 2018 | $129.19 | $35.55 | 3.63x | $93.64 | $3.2M | 91.1K | 48 |
| 2019 | $142.11 | $40.12 | 3.54x | $101.99 | $2.4M | 60.5K | 46 |
| 2020 | $275.72 | $71.58 | 3.85x | $204.14 | $1.5M | 21.2K | 39 |
| 2021 | $244.99 | $73.05 | 3.35x | $171.94 | $1.8M | 25.3K | 44 |
| 2022 | $121.96 | $54.17 | 2.25x | $67.79 | $4.3M | 78.5K | 38 |
| 2023 | $100.90 | $44.39 | 2.27x | $56.51 | $4.4M | 100.2K | 40 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J2323 | Injection, natalizumab, 1 mg | 451.2K | $6.5M | $14.39 | 3.02x |
| 99489 | Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month | 60.3K | $3.2M | $53.22 | 1.43x |
| J1561 | Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg | 88.1K | $2.8M | $31.46 | 3.68x |
| 95886 | Needle measurement of electrical activity in arm or leg muscles, complete study | 37.9K | $2.7M | $71.50 | 3.59x |
| 95913 | Nerve conduction, 13 or more studies | 9.4K | $2.1M | $227.03 | 3.74x |
| 95951 | Monitoring and localization of seizure activity over 24-hour period using 16-channel electroencephalograph (EEG) | 1.3K | $1.5M | $1.2K | 3.06x |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 16.3K | $1.4M | $88.14 | 3.53x |
| 99487 | Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month | 11.8K | $1.2M | $98.18 | 1.46x |
| 95813 | Measurement of brain wave activity (eeg), 61-119 minutes | 2.6K | $815.6K | $315.15 | 4.40x |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 12.9K | $658.9K | $51.21 | 3.87x |
| J1568 | Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg | 20.4K | $605.7K | $29.70 | 3.83x |
| 95938 | Placement of skin electrodes and measurement of stimulated sites on arms and legs | 1.9K | $499.6K | $265.90 | 2.14x |
| 20550 | Injection into tendon or ligament | 16.9K | $396.9K | $23.42 | 8.37x |
| 92546 | Test for abnormal eye movement using a rotating chair | 4.1K | $338.3K | $81.71 | 2.08x |
| 92540 | Evaluation and testing for balance with recording | 4.2K | $320.6K | $76.33 | 2.26x |
| 62322 | Injection of substance into lower spine canal | 2.4K | $267.4K | $110.45 | 5.73x |
| 95957 | Digital analysis of electrical brain wave activity (EEG) | 1.3K | $261.8K | $205.82 | 3.47x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 2.2K | $258.6K | $120.00 | 3.97x |
| 62311 | Injections of substances into lower or sacral spine | 1.9K | $249.8K | $129.58 | 4.41x |
| 92548 | Test for balance and posture | 4.2K | $225.8K | $53.30 | 3.19x |
This provider submits charges 3.33 times higher than what Medicare actually pays.
A markup ratio of 3.33x means for every $100 Medicare pays, this provider initially charges $333. This is higher 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.
Other Neurology providers in TX for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Guy Burrows, M.D. | Shenandoah, TX | $35.6M | ✓ Clear |
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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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