Raymond M Bautista, DPM

Offices

1 location · Kim Foot and Ankle Medical Centers of Long Beach · 3 clinicians in this group

Looking this up.

Hospitals listed: 553107 · Memorialcare Long Beach Medical Center. That is not proof they admit you there this week.

Plan participation

Not verified

We could not verify current plan participation for this doctor. This does not mean they are out of network. Call Dr. Bautista’s office at (562) 426-2551 to ask if they take your plan before you enroll.

Hospitals they work in

1 hospital

These rate the hospital, not this clinician. Most measures at most hospitals are no different from the national rate.

Memorialcare Long Beach Medical CenterLong Beach, CAAcute Care Hospital · Voluntary non-profit - Other · No emergency departmentPart of MemorialCare Health System, which runs 4 hospitalsPatients rate it 3 of 5 · 69% would definitely recommend it
Overall rating: 2 of 5 starsBetter than the national rate — Catheter Associated Urinary Tract Infections (ICU + select Wards): 0.505, Oct 2024 – Sep 2025Better than the national rate — Clostridium Difficile (C.Diff): 0.596, Oct 2024 – Sep 2025

See every measure and the patient survey for Memorialcare Long Beach Medical Center

Behind the star rating — Deaths: 0 better, 8 the same, 0 worse of 8 measures. Safety: 1 better, 7 the same, 0 worse of 8 measures. Readmissions: 0 better, 10 the same, 1 worse of 11 measures. The star rating is worked out from an earlier period than the measures below, so the two can disagree.

Sort by

Every scored measure at Memorialcare Long Beach Medical Center

Catheter Associated Urinary Tract Infections (ICU + select Wards)Infections	0.505	Better	Oct 2024 – Sep 2025
Clostridium Difficile (C.Diff)Infections	0.596	Better	Oct 2024 – Sep 2025
Abdominopelvic accidental puncture or laceration rateComplications and deaths	1.01 (0.06 to 1.95) · 1,454 cases	No different	Jul 2022 – Jun 2024
CMS Medicare PSI 90: Patient safety and adverse events compositeComplications and deaths	1.09 (0.8 to 1.37)	No different	Jul 2022 – Jun 2024
Death rate among surgical inpatients with serious treatable complicationsComplications and deaths	203.2 (163.37 to 243.02) · 113 cases	No different	Jul 2022 – Jun 2024
Death rate for CABG surgery patientsComplications and deaths	2.1 · 45 cases	None	Jul 2022 – Jun 2025
Death rate for COPD patientsComplications and deaths	6.8 · 76 cases	None	Jul 2022 – Jun 2025
Death rate for heart attack patientsComplications and deaths	12 · 110 cases	None	Jul 2022 – Jun 2025
Death rate for heart failure patientsComplications and deaths	10.5 · 272 cases	None	Jul 2022 – Jun 2025
Death rate for pneumonia patientsComplications and deaths	13.7 · 247 cases	None	Jul 2022 – Jun 2025
Death rate for stroke patientsComplications and deaths	10.7 · 411 cases	None	Jul 2023 – Jun 2025
Hybrid Hospital-Wide All-Cause Risk Standardized Mortality RateComplications and deaths	3.4 · 3,352 cases	None	Jul 2024 – Jun 2025
Iatrogenic pneumothorax rateComplications and deaths	0.3 (0.1 to 0.5) · 5,922 cases	No different	Jul 2022 – Jun 2024
In-hospital fall-associated fracture rateComplications and deaths	0.24 (0.05 to 0.43) · 6,111 cases	No different	Jul 2022 – Jun 2024
Perioperative pulmonary embolism or deep vein thrombosis rateComplications and deaths	3.51 (1.59 to 5.44) · 1,808 cases	No different	Jul 2022 – Jun 2024
Postoperative acute kidney injury requiring dialysis rateComplications and deaths	2.46 (0.92 to 4.01) · 745 cases	No different	Jul 2022 – Jun 2024
Postoperative hemorrhage or hematoma rateComplications and deaths	1.99 (0.58 to 3.41) · 1,658 cases	No different	Jul 2022 – Jun 2024
Postoperative respiratory failure rateComplications and deaths	13.23 (7.34 to 19.12) · 790 cases	No different	Jul 2022 – Jun 2024
Postoperative sepsis rateComplications and deaths	6.78 (3.38 to 10.19) · 786 cases	No different	Jul 2022 – Jun 2024
Postoperative wound dehiscence rateComplications and deaths	1.92 (0.46 to 3.38) · 474 cases	No different	Jul 2022 – Jun 2024
Pressure ulcer rateComplications and deaths	0.27 (0 to 0.86) · 5,287 cases	No different	Jul 2022 – Jun 2024
Rate of complications for hip/knee replacement patientsComplications and deaths	7.4 · 72 cases	None	Apr 2023 – Mar 2025
Central Line Associated Bloodstream Infection (ICU + select Wards)Infections	0.834	No different	Oct 2024 – Sep 2025
MRSA BacteremiaInfections	1.27	No different	Oct 2024 – Sep 2025
SSI - Abdominal HysterectomyInfections	1.975	No different	Oct 2024 – Sep 2025
SSI - Colon SurgeryInfections	1.394	No different	Oct 2024 – Sep 2025
Acute Myocardial Infarction (AMI) 30-Day Readmission RateUnplanned return visits	14.9 · 227 cases	None	Jul 2023 – Jun 2025
Heart failure (HF) 30-Day Readmission RateUnplanned return visits	19.4 · 559 cases	None	Jul 2023 – Jun 2025
Hospital return days for heart attack patientsUnplanned return visits	30.7 · 110 cases	None	Jul 2022 – Jun 2025
Hospital return days for heart failure patientsUnplanned return visits	-7.8 · 318 cases	None	Jul 2022 – Jun 2025
Hospital return days for pneumonia patientsUnplanned return visits	8 · 261 cases	None	Jul 2022 – Jun 2025
Pneumonia (PN) 30-Day Readmission RateUnplanned return visits	16 · 435 cases	None	Jul 2023 – Jun 2025
Rate of emergency department (ED) visits for patients receiving outpatient chemotherapyUnplanned return visits	5 (3.4 to 7.2) · 157 cases	No different	Jan 2024 – Dec 2024
Rate of inpatient admissions for patients receiving outpatient chemotherapyUnplanned return visits	12.9 (9.8 to 16.6) · 157 cases	No different	Jan 2024 – Dec 2024
Rate of readmission after hip/knee replacementUnplanned return visits	5.8 · 68 cases	None	Jul 2023 – Jun 2025
Rate of readmission for CABGUnplanned return visits	9.1 · 72 cases	None	Jul 2023 – Jun 2025
Rate of readmission for chronic obstructive pulmonary disease (COPD) patientsUnplanned return visits	20 · 204 cases	None	Jul 2023 – Jun 2025
Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)Unplanned return visits	13.3 (9.8 to 17.8) · 75 cases	No different	Jan 2022 – Dec 2024
Ratio of unplanned hospital visits after hospital outpatient surgeryUnplanned return visits	0.9 (0.7 to 1.2) · 374 cases	No different	Jan 2024 – Dec 2024

What patients said (2,188 patients answered, 18% of those asked)

Sort by

Patient survey stars by topic at Memorialcare Long Beach Medical Center

Cleanliness	4
Nurse communication	3
Doctor communication	2
Communication about medicines	2
Discharge information	3
Overall hospital rating	3
Quietness	2
Recommend hospital	4

Sort by

Share of patients giving the best answer at Memorialcare Long Beach Medical Center

Room was "always" clean	71%
Nurses "always" communicated well	75%
Doctors "always" communicated well	73%
Staff "always" explained	56%
Yes, staff "did" give patients this information	85%
Yes, staff "did" give patients information about help after discharge	85%
Doctors "always" explained things so they could understand	68%
Doctors "always" listened carefully	72%
Doctors "always" treated them with courtesy and respect	80%
Patients who gave a rating of "9" or "10" (high)	67%
Staff "always" explained new medications	71%
Nurses "always" explained things so they could understand	71%
Nurses "always" listened carefully	72%
Nurses "always" treated them with courtesy and respect	82%
"Always" quiet at night	46%
"YES", patients would definitely recommend the hospital	69%
Staff "always" explained possible side effects	42%
Yes, staff "did" give patients information about possible symptoms	85%

Original Medicare doctor bills

$1,128,961

Medicare paid this office $1,128,961 for 432 people.

This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.

Sort by

Largest Original Medicare bills

Short return visit (20+ min)	394	$119,306	$66
Therapy procedure using ultrasound	19	$38,681	$352
Removal of skin and tissue, 20.0 sq cm or less	43	$36,980	$105
Removal of fingernails or toenails, 6 or more nails	243	$27,246	$33
Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less	11	$5,815	$121

See all 16 services

Sort by

Every Original Medicare service billed

Short return visit (20+ min)	394	$119,306	$66
Therapy procedure using ultrasound	19	$38,681	$352
Removal of skin and tissue, 20.0 sq cm or less	43	$36,980	$105
Removal of fingernails or toenails, 6 or more nails	243	$27,246	$33
Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less	11	$5,815	$121
New patient visit (30+ min)	57	$4,306	$76
Initial hospital care with moderate level of medical decision making at least 75 minutes	23	$3,080	$128
Destruction of skin growth, 1-14 growths	13	$3,000	$94
Ultrasound study of arm and leg arteries	40	$2,744	$67
Biopsy of fingernail or toenail	23	$2,707	$97
X-ray of foot, 2 views	58	$2,273	$23
Testing of autonomic (sympathetic) nervous system function	15	$1,594	$100
Simple separation of fingernail or toenail from nail bed, first nail	13	$1,582	$93
Placement of strapping to ankle or foot	39	$1,214	$21
Injection into tendon or ligament	15	$976	$38
X-ray of ankle, 2 views	17	$746	$24

Procedures Medicare counted

Sort by

Procedure volume Medicare published

Removal of nail tissue	623	More than 86% of doctors who do this
Removal of skin lesions	29	More than 68% of doctors who do this
Removal of tissue	220	More than 92% of doctors who do this
Removal or shaving of skin growth	86	More than 84% of doctors who do this
Skin biopsy	1-10	None

Procedures year by year

Procedures billed to Original Medicare by year
Procedure	2019	2020	2021	2022	2023	2024
Removal of fingernails or toenails, 6 or more nails	1,129	867	569	577	726	814
Removal of skin and tissue, 20.0 sq cm or less	257	324	225	243	160	352
Injection into tendon or ligament	71	47	49	36	27	26
Removal of noncancer thickened skin growth, 1 growth	121	81	43	–	–	–
Biopsy of fingernail or toenail	41	37	29	28	31	28
Placement of strapping to ankle or foot	38	–	18	25	25	58

Times billed to Original Medicare each year. A blank year means fewer than 11 people had it, or none: Medicare does not publish smaller counts. Medicare Advantage patients are not included.

Who their Medicare patients are

432 Original Medicare patients in 2024. Average age 74 · Under 65 14% · 85 and older 16% · Women 57% · Also on Medicaid 53% · Health risk score 2.11. Above the middle of the specialty; the typical podiatry clinician is at 1.55.

Conditions among them: High blood pressure 75% · Diabetes 64% · Chronic kidney disease 42% · Coronary heart disease 34% · Heart failure 27% · Depression 24% · Atrial fibrillation 21% · COPD 20% · Cancer 14% · Dementia 11% · Stroke 11%.

The office billed $1,535,193, Medicare allowed $1,442,455 and paid $1,128,961; for 4,351 services of 45 kinds; $860,691 of it was for drugs given in the office and $268,270 for care.

Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.

Year by year

Sort by

Original Medicare by year

2024	432	4,351	74	2.11	$1,535,193	$1,128,961
2023	450	3,368	73	2.28	$479,041	$320,569
2022	446	2,863	73	2.34	$349,663	$250,795
2021	448	2,767	72	2.28	$286,257	$205,858
2020	430	3,248	72	2.66	$296,885	$218,059
2019	463	3,841	73	2.55	$329,311	$238,035
2018	518	4,434	73	2.30	$369,297	$267,692
2017	501	3,856	72	2.28	$318,576	$226,068
2016	473	3,564	71	2.45	$298,281	$211,708
2015	450	3,789	71	2.50	$319,494	$226,609
2014	421	2,942	72	2.26	$254,703	$168,317
2013	448	2,914	72	2.27	$255,126	$170,091

Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.

See the services billed each year

2023: 14 services

Sort by

Original Medicare services billed in 2023

Short return visit (20+ min)	398	$121,872	$72
Therapy procedure using ultrasound	25	$109,863	$418
Removal of fingernails or toenails, 6 or more nails	232	$26,286	$36
Removal of skin and tissue, 20.0 sq cm or less	33	$17,786	$111
New patient visit (30+ min)	63	$4,911	$78
Initial hospital care with moderate level of medical decision making at least 75 minutes	33	$4,795	$137
Biopsy of fingernail or toenail	24	$3,287	$106
Ultrasound study of arm and leg arteries	33	$2,501	$76
X-ray of foot, 2 views	47	$1,796	$23
Testing of autonomic (sympathetic) nervous system function	16	$1,790	$112
Simple separation of fingernail or toenail from nail bed, first nail	13	$1,469	$98
Injection into tendon or ligament	20	$1,277	$47
X-ray of ankle, 2 views	22	$950	$26
Placement of strapping to ankle or foot	22	$564	$23

2022: 11 services

Sort by

Original Medicare services billed in 2022

Short return visit (20+ min)	386	$108,019	$73
Removal of skin and tissue, 20.0 sq cm or less	38	$27,621	$114
Removal of fingernails or toenails, 6 or more nails	213	$20,935	$36
New patient visit (30+ min)	78	$6,321	$81
Initial hospital care with moderate level of medical decision making at least 75 minutes	32	$5,696	$168
Biopsy of fingernail or toenail	27	$2,967	$106
X-ray of foot, 2 views	62	$2,664	$25
Simple separation of fingernail or toenail from nail bed, first nail	16	$1,980	$99
Injection into tendon or ligament	24	$1,709	$47
X-ray of ankle, 2 views	17	$750	$25
Placement of strapping to ankle or foot	22	$614	$25

2021: 14 services

Sort by

Original Medicare services billed in 2021

Short return visit (20+ min)	377	$103,925	$76
Removal of skin and tissue, 20.0 sq cm or less	41	$26,641	$118
Removal of fingernails or toenails, 6 or more nails	234	$21,716	$38
Initial hospital care with moderate level of medical decision making at least 75 minutes	40	$6,747	$169
New patient visit (30+ min)	70	$6,078	$87
X-ray of foot, 2 views	72	$2,853	$24
Biopsy of fingernail or toenail	27	$2,719	$94
Removal of noncancer thickened skin growth, 1 growth	34	$2,529	$59
Injection into tendon or ligament	32	$2,304	$47
Simple separation of fingernail or toenail from nail bed, first nail	20	$1,887	$94
X-ray of ankle, 2 views	26	$1,263	$27
Application of walking cast covering below knee to toe	11	$1,090	$64
Cast supplies, short leg cast, adult (11 years +), fiberglass	11	$552	$32
Placement of strapping to ankle or foot	14	$451	$25

2020: 13 services

Sort by

Original Medicare services billed in 2020

Short return visit (20+ min)	355	$79,513	$64
Removal of skin and tissue, 20.0 sq cm or less	53	$37,322	$115
Removal of fingernails or toenails, 6 or more nails	276	$34,392	$40
Short return visit	74	$8,060	$38
Initial hospital care with moderate level of medical decision making at least 75 minutes	42	$7,535	$171
Incision of foot bone	11	$6,218	$518
New patient visit (30+ min)	80	$6,123	$77
Removal of noncancer thickened skin growth, 1 growth	46	$4,260	$53
Biopsy of fingernail or toenail	33	$3,792	$102
Simple separation of fingernail or toenail from nail bed, first nail	20	$2,677	$99
Injection into tendon or ligament	22	$2,211	$47
X-ray of foot, 2 views	57	$2,036	$22
X-ray of ankle, 2 views	14	$726	$27

2019: 13 services

Sort by

Original Medicare services billed in 2019

Short return visit (20+ min)	383	$99,310	$62
Removal of fingernails or toenails, 6 or more nails	310	$44,231	$39
Removal of skin and tissue, 20.0 sq cm or less	43	$27,959	$109
Initial hospital care with moderate level of medical decision making at least 75 minutes	46	$8,143	$163
Removal of noncancer thickened skin growth, 1 growth	65	$5,907	$49
New patient visit (30+ min)	63	$5,052	$80
Short return visit	92	$4,636	$41
Biopsy of fingernail or toenail	36	$4,206	$103
Injection into tendon or ligament	22	$3,144	$44
X-ray of foot, 2 views	58	$2,319	$23
Simple separation of fingernail or toenail from nail bed, first nail	20	$2,160	$94
Placement of strapping to ankle or foot	16	$957	$25
X-ray of ankle, 2 views	20	$886	$25

2018: 14 services

Sort by

Original Medicare services billed in 2018

Short return visit (20+ min)	437	$119,149	$60
Removal of fingernails or toenails, 6 or more nails	325	$42,146	$38
Removal of skin and tissue, 20.0 sq cm or less	53	$33,557	$105
Removal of noncancer thickened skin growth, 1 growth	93	$8,605	$41
New patient visit (30+ min)	88	$7,478	$85
Injection into tendon or ligament	45	$6,421	$43
Testing of autonomic (sympathetic) nervous system function	51	$6,040	$118
Initial hospital care with moderate level of medical decision making at least 75 minutes	35	$6,011	$172
Testing of autonomic nervous system function and heart rate response to deep breathing	51	$3,811	$75
X-ray of foot, 2 views	79	$3,323	$23
Simple separation of fingernail or toenail from nail bed, first nail	30	$3,206	$89
Biopsy of fingernail or toenail	27	$3,035	$108
X-ray of ankle, 2 views	27	$1,219	$25
Placement of strapping to ankle or foot	11	$922	$22

2017: 12 services

Sort by

Original Medicare services billed in 2017

Short return visit (20+ min)	430	$110,290	$59
Removal of fingernails or toenails, 6 or more nails	311	$34,948	$37
Removal of skin and tissue, 20.0 sq cm or less	47	$18,367	$101
New patient visit (30+ min)	100	$8,005	$80
Initial hospital care with moderate level of medical decision making at least 75 minutes	33	$5,894	$164
Injection into tendon or ligament	39	$5,494	$41
Removal of noncancer thickened skin growth, 1 growth	71	$5,136	$40
X-ray of foot, 2 views	83	$3,150	$22
Biopsy of fingernail or toenail	22	$2,584	$117
Simple separation of fingernail or toenail from nail bed, first nail	27	$2,518	$79
Placement of strapping to ankle or foot	27	$1,152	$22
X-ray of ankle, 2 views	25	$921	$23

2016: 13 services

Sort by

Original Medicare services billed in 2016

Short return visit (20+ min)	409	$104,812	$59
Removal of fingernails or toenails, 6 or more nails	288	$32,567	$37
Removal of skin and tissue, 20.0 sq cm or less	22	$9,661	$103
New patient visit (30+ min)	101	$8,264	$82
Injection into tendon or ligament	44	$6,292	$45
Destruction of skin growth, 1-14 growths	32	$5,486	$93
Initial hospital care with moderate level of medical decision making at least 75 minutes	31	$5,248	$164
X-ray of foot, 2 views	86	$3,671	$22
Biopsy of fingernail or toenail	30	$3,439	$115
Simple separation of fingernail or toenail from nail bed, first nail	22	$2,159	$83
Placement of strapping to ankle or foot	24	$991	$22
X-ray of ankle, 2 views	19	$974	$24
Removal of noncancer thickened skin growth, 1 growth	14	$806	$42

2015: 15 services

Sort by

Original Medicare services billed in 2015

Short return visit (20+ min)	396	$106,266	$59
Removal of fingernails or toenails, 6 or more nails	280	$31,220	$37
Removal of skin and tissue, 20.0 sq cm or less	23	$14,655	$103
Destruction of skin growth, 1-14 growths	57	$12,622	$97
Ultrasound study of arm and leg arteries	155	$10,550	$66
New patient visit (30+ min)	86	$7,002	$81
Initial hospital care with moderate level of medical decision making at least 75 minutes	34	$5,571	$159
Injection into tendon or ligament	34	$5,560	$46
X-ray of foot, 2 views	91	$3,992	$21
Biopsy of fingernail or toenail	26	$3,159	$113
Simple separation of fingernail or toenail from nail bed, first nail	25	$2,224	$82
X-ray of ankle, 2 views	22	$1,183	$24
Removal of noncancer thickened skin growth, 1 growth	21	$1,003	$42
X-ray of foot, minimum of 3 views	11	$489	$26
Placement of strapping to ankle or foot	12	$314	$22

2014: 14 services

Sort by

Original Medicare services billed in 2014

Short return visit (20+ min)	356	$77,997	$59
Removal of fingernails or toenails, 6 or more nails	269	$29,998	$37
New patient visit (30+ min)	101	$8,554	$85
Ultrasound study of arm and leg arteries	85	$5,510	$63
X-ray of foot, 2 views	92	$4,848	$24
Initial hospital care with moderate level of medical decision making at least 75 minutes	22	$3,760	$163
Injection into tendon or ligament	24	$3,651	$46
Biopsy of fingernail or toenail	22	$3,248	$96
Removal of skin and tissue, 20.0 sq cm or less	11	$2,962	$96
Simple separation of fingernail or toenail from nail bed, first nail	20	$2,128	$85
Application of walking cast covering below knee to toe	12	$1,377	$66
X-ray of ankle, 2 views	23	$1,196	$25
Cast supplies, short leg cast, adult (11 years +), fiberglass	12	$643	$31
Placement of strapping to ankle or foot	15	$570	$32

2013: 16 services

Sort by

Original Medicare services billed in 2013

Short return visit (20+ min)	371	$82,845	$57
Removal of fingernails or toenails, 6 or more nails	244	$21,534	$36
New patient visit (30+ min)	103	$8,278	$80
Ultrasound study of arm and leg arteries	72	$6,031	$84
Initial hospital care with moderate level of medical decision making at least 75 minutes	37	$6,016	$163
Biopsy of fingernail or toenail	32	$4,315	$98
Injection into tendon or ligament	28	$4,111	$43
Removal of skin and tissue, 20.0 sq cm or less	13	$4,042	$96
X-ray of foot, 2 views	72	$3,277	$24
Simple separation of fingernail or toenail from nail bed, first nail	22	$2,381	$79
Removal of tissue from wound, 20.0 sq cm or less	23	$2,237	$66
Application of walking cast covering below knee to toe	11	$1,747	$67
X-ray of ankle, 2 views	23	$979	$25
Cast supplies, short leg cast, adult (11 years +), fiberglass	11	$809	$31
X-ray of foot, minimum of 3 views	14	$723	$29
Placement of strapping to ankle or foot	12	$472	$31

Medicaid work

$932 in 2024

Medicaid paid $932 for 389 billed services this clinician did in 2024, up to 30 people in a month for one service.

Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.

Sort by

Largest Medicaid services in 2024

Short return visit (20+ min)	283	$629
Debridement of nail(s) by any method(s); 6 or more	106	$303

Sort by

Medicaid work by year

2024	389	2	30	$932
2023	437	2	30	$2,703
2022	224	2	25	$2,212
2021	13	1	12	$105
2020	141	2	14	$1,795
2019	335	3	24	$2,589
2018	609	2	43	$4,091

See the largest Medicaid services in earlier years

2023

Sort by

Largest Medicaid services in 2023

Short return visit (20+ min)	296	$1,990
Debridement of nail(s) by any method(s); 6 or more	141	$713

2022

Sort by

Largest Medicaid services in 2022

Short return visit (20+ min)	168	$1,952
Debridement of nail(s) by any method(s); 6 or more	56	$260

2021

Sort by

Largest Medicaid services in 2021

Return visit (30+ min)	13	$105

2020

Sort by

Largest Medicaid services in 2020

Short return visit (20+ min)	87	$1,340
Debridement of nail(s) by any method(s); 6 or more	54	$455

2019

Sort by

Largest Medicaid services in 2019

Short return visit (20+ min)	154	$1,096
Debridement of nail(s) by any method(s); 6 or more	152	$1,027
Return visit (30+ min)	29	$466

2018

Sort by

Largest Medicaid services in 2018

Short return visit (20+ min)	396	$2,886
Debridement of nail(s) by any method(s); 6 or more	213	$1,205

Drugs they prescribed that Part D paid

$55,702

Pharmacies billed $55,702 in 2024.

This is pharmacy cost, not the office bill, and not what patients paid.

Opioids were 21% of their Part D prescriptions (206 of 993) in 2024. Above the middle of the specialty; the typical podiatry clinician is at 5%.

870 generic and 123 brand-name prescriptions · $55,702 in drug cost · 69 antibiotic prescriptions to 39 people.

Part D prescriptions only. The opioid rate is opioid prescriptions as a share of all this clinician's Part D prescriptions; surgeons and pain specialists run higher than others, so it is shown against the same specialty.

Sort by

Largest Part D drug costs

Santyl	14	$13,537	$967
Ciclopirox	171	$8,667	$51
Hydrocodone-Acetaminophen	120	$3,673	$31
Diclofenac	60	$2,173	$36
Ketoconazole	55	$1,373	$25

See all 16 drugs

Sort by

Every Part D drug this clinician prescribed

Santyl	14	$13,537	$967
Ciclopirox	171	$8,667	$51
Hydrocodone-Acetaminophen	120	$3,673	$31
Diclofenac	60	$2,173	$36
Ketoconazole	55	$1,373	$25
Acetaminophen-Codeine	47	$1,139	$24
Ciclopirox	63	$963	$15
Ammonium Lactate	59	$919	$16
Butalbital-Aspirin-Caffeine	11	$893	$81
Ssd	67	$732	$11
Triamcinolone Acetonide	41	$269	$7
Doxycycline Hyclate	42	$259	$6
Oxycodone-Acetaminophen	22	$173	$8
Cephalexin	15	$140	$9
Silver Sulfadiazine	17	$138	$8
Tramadol	16	$50	$3

Year by year

Sort by

Part D prescribing by year

2024	993	346	21% (206)	12%	$55,702
2023	1,016	301	21% (211)	9%	$48,519
2022	1,184	312	17% (203)	None	$54,392
2021	1,081	271	19% (209)	None	$44,738
2020	1,255	275	16% (206)	13%	$100,826
2019	1,159	288	17% (192)	16%	$77,345
2018	1,209	281	18% (222)	21%	$112,156
2017	932	245	24% (224)	18%	$82,449
2016	825	215	26% (214)	15%	$95,127
2015	913	196	23% (205)	18%	$90,261
2014	794	187	26% (204)	None	$53,992
2013	606	156	28% (169)	None	$25,342

Part D prescriptions only. A drug prescribed to fewer than 11 people in a year is hidden.

See the drugs prescribed each year

2023: 20 drugs

Sort by

Part D drugs prescribed in 2023

Ciclopirox	172	$9,764	$57
Diclofenac	136	$3,562	$26
Hydrocodone-Acetaminophen	143	$3,360	$23
Ketoconazole	70	$3,214	$46
Pregabalin	13	$1,669	$128
Ciclopirox	21	$817	$39
Ssd	51	$793	$16
Erythromycin	12	$695	$58
Triamcinolone Acetonide	50	$664	$13
Cephalexin	19	$548	$29
Ammonium Lactate	23	$494	$21
Doxycycline Hyclate	28	$440	$16
Fluconazole	14	$412	$29
Clotrimazole	13	$388	$30
Acetaminophen-Codeine	28	$347	$12
Silver Sulfadiazine	11	$208	$19
Sulfamethoxazole-Trimethoprim	19	$126	$7
Tramadol	30	$121	$4
Naproxen	12	$113	$9
Gabapentin	16	$109	$7

2022: 21 drugs

Sort by

Part D drugs prescribed in 2022

Santyl	15	$12,512	$834
Ciclopirox	169	$10,707	$63
Ketoconazole	97	$6,120	$63
Diclofenac	208	$5,378	$26
Hydrocodone-Acetaminophen	143	$3,042	$21
Ssd	76	$2,028	$27
Fluconazole	23	$1,568	$68
Gabapentin	30	$1,404	$47
Clotrimazole	20	$690	$35
Ammonium Lactate	18	$518	$29
Ciclopirox	14	$473	$34
Acetaminophen-Codeine	23	$473	$21
Hydralazine	12	$343	$29
Triamcinolone Acetonide	22	$306	$14
Sulfamethoxazole-Trimethoprim	69	$249	$4
Mupirocin	20	$209	$10
Silver Sulfadiazine	12	$207	$17
Naproxen	18	$156	$9
Tramadol	27	$130	$5
Ibuprofen	18	$120	$7
Cephalexin	20	$115	$6

2021: 18 drugs

Sort by

Part D drugs prescribed in 2021

Santyl	35	$11,049	$316
Ciclopirox	99	$6,767	$68
Diclofenac	173	$6,736	$39
Hydrocodone-Acetaminophen	154	$3,457	$22
Ketoconazole	68	$3,397	$50
Ssd	46	$1,215	$26
Ammonium Lactate	37	$1,069	$29
Gabapentin	26	$851	$33
Clotrimazole	24	$658	$27
Naproxen	49	$366	$7
Acetaminophen-Codeine	22	$365	$17
Triamcinolone Acetonide	37	$307	$8
Ibuprofen	25	$274	$11
Mupirocin	36	$229	$6
Cephalexin	22	$170	$8
Sulfamethoxazole-Trimethoprim	36	$163	$5
Tramadol	27	$87	$3
Zolpidem	14	$68	$5

2020: 24 drugs

Sort by

Part D drugs prescribed in 2020

Regranex	14	$32,197	$2,300
Diclofenac	261	$19,659	$75
Santyl	61	$19,050	$312
Ciclopirox	110	$6,924	$63
Ketoconazole	55	$3,117	$57
Hydrocodone-Acetaminophen	142	$2,695	$19
Lidocaine	28	$2,183	$78
Ammonium Lactate	61	$1,810	$30
Clotrimazole	37	$1,168	$32
Ssd	27	$1,006	$37
Erythromycin	13	$758	$58
Gabapentin	20	$454	$23
Acetaminophen-Codeine	27	$435	$16
Oxycodone-Acetaminophen	13	$419	$32
Mupirocin	46	$380	$8
Naproxen	51	$358	$7
Triamcinolone Acetonide	39	$273	$7
Zolpidem	16	$220	$14
Cephalexin	22	$126	$6
Levofloxacin	18	$123	$7
Sulfamethoxazole-Trimethoprim	21	$118	$6
Ibuprofen	14	$110	$8
Tramadol	24	$110	$5
Temazepam	11	$32	$3

2019: 23 drugs

Sort by

Part D drugs prescribed in 2019

Diclofenac	161	$22,230	$138
Ciclopirox	154	$9,356	$61
Lidocaine	34	$6,330	$186
Santyl	17	$5,008	$295
Ketoconazole	48	$3,451	$72
Voltaren	48	$3,268	$68
Hydrocodone-Acetaminophen	137	$2,987	$22
Clotrimazole	54	$2,065	$38
Ammonium Lactate	57	$1,704	$30
Ssd	43	$1,422	$33
Fluocinonide	11	$676	$61
Oxycodone-Acetaminophen	19	$660	$35
Mupirocin	32	$544	$17
Cephalexin	56	$495	$9
Triamcinolone Acetonide	36	$339	$9
Naproxen	39	$290	$7
Gabapentin	13	$205	$16
Ibuprofen	17	$186	$11
Clindamycin	13	$142	$11
Acetaminophen-Codeine	30	$134	$4
Sulfamethoxazole-Trimethoprim	12	$70	$6
Allopurinol	12	$65	$5
Zolpidem	12	$24	$2

2018: 21 drugs

Sort by

Part D drugs prescribed in 2018

Santyl	32	$14,394	$450
Diclofenac	81	$12,563	$155
Ciclopirox	174	$12,104	$70
Lidocaine	68	$9,956	$146
Voltaren	95	$8,675	$91
Hydrocodone-Acetaminophen	182	$4,942	$27
Ketoconazole	59	$4,627	$78
Econazole Nitrate	15	$3,373	$225
Clotrimazole	85	$2,897	$34
Lidocaine-Prilocaine	19	$1,481	$78
Silver Sulfadiazine	24	$874	$36
Oxycodone-Acetaminophen	20	$861	$43
Ssd	23	$841	$37
Ammonium Lactate	21	$428	$20
Triamcinolone Acetonide	21	$278	$13
Sulfamethoxazole-Trimethoprim	41	$243	$6
Gabapentin	15	$153	$10
Naproxen	12	$141	$12
Cephalexin	15	$110	$7
Indomethacin	16	$103	$6
Ibu	11	$85	$8

2017: 21 drugs

Sort by

Part D drugs prescribed in 2017

Diclofenac	58	$12,386	$214
Lidocaine	38	$12,192	$321
Ciclopirox	134	$9,261	$69
Econazole Nitrate	33	$6,847	$207
Voltaren	42	$5,692	$136
Santyl	20	$5,002	$250
Hydrocodone-Acetaminophen	172	$3,727	$22
Colchicine	14	$2,805	$200
Ketoconazole	33	$2,009	$61
Clotrimazole	60	$1,972	$33
Oxycodone-Acetaminophen	20	$982	$49
Ssd	22	$707	$32
Silver Sulfadiazine	26	$474	$18
Ammonium Lactate	17	$304	$18
Triamcinolone Acetonide	16	$288	$18
Tramadol	14	$163	$12
Clindamycin	12	$145	$12
Cephalexin	14	$115	$8
Naproxen	15	$102	$7
Sulfamethoxazole-Trimethoprim	20	$100	$5
Ibuprofen	12	$89	$7

2016: 19 drugs

Sort by

Part D drugs prescribed in 2016

Santyl	13	$18,313	$1,409
Econazole Nitrate	62	$13,574	$219
Ciclopirox	137	$8,286	$60
Lidocaine	17	$4,658	$274
Hydrocodone-Acetaminophen	164	$4,387	$27
Voltaren	36	$4,199	$117
Diclofenac	15	$2,884	$192
Clotrimazole	46	$2,454	$53
Ketoconazole	13	$993	$76
Oxycodone-Acetaminophen	12	$649	$54
Silver Sulfadiazine	19	$608	$32
Oxycodone	11	$493	$45
Gabapentin	11	$401	$36
Acetaminophen-Codeine	14	$306	$22
Ibuprofen	16	$174	$11
Naproxen	31	$167	$5
Zolpidem	13	$144	$11
Sulfamethoxazole-Trimethoprim	19	$137	$7
Losartan	11	$61	$6

2015: 20 drugs

Sort by

Part D drugs prescribed in 2015

Regranex	16	$22,957	$1,435
Econazole Nitrate	79	$19,384	$245
Ciclopirox	155	$8,154	$53
Hydrocodone-Acetaminophen	143	$3,791	$27
Voltaren	41	$3,105	$76
Santyl	11	$2,331	$212
Duloxetine	13	$1,609	$124
Clotrimazole	28	$1,367	$49
Oxycodone-Acetaminophen	17	$1,155	$68
Silver Sulfadiazine	20	$736	$37
Acetaminophen-Codeine	21	$534	$25
Carisoprodol	17	$313	$18
Hydromorphone	11	$185	$17
Clindamycin	12	$148	$12
Naproxen	19	$140	$7
Zolpidem	12	$108	$9
Ibuprofen	11	$97	$9
Sulfamethoxazole-Trimethoprim	23	$83	$4
Metformin	11	$76	$7
Cephalexin	11	$70	$6

2014: 14 drugs

Sort by

Part D drugs prescribed in 2014

Ciclopirox	141	$7,532	$53
Lidoderm	14	$3,671	$262
Hydrocodone-Acetaminophen	144	$2,946	$20
Humulin N Kwikpen	12	$2,136	$178
Econazole Nitrate	35	$1,972	$56
Oxycodone-Acetaminophen	20	$1,255	$63
Clotrimazole	36	$1,104	$31
Silver Sulfadiazine	24	$909	$38
Novolog Flexpen	11	$898	$82
Carisoprodol	35	$770	$22
Acetaminophen-Codeine	24	$411	$17
Clindamycin	14	$167	$12
Hydromorphone	13	$126	$10
Omeprazole	21	$121	$6

2013: 12 drugs

Sort by

Part D drugs prescribed in 2013

Ciclopirox	91	$5,061	$56
Hydrocodone-Acetaminophen	144	$1,824	$13
Ciclopirox	12	$1,117	$93
Clotrimazole	33	$966	$29
Silver Sulfadiazine	18	$673	$37
Acetaminophen-Codeine	13	$247	$19
Ciprofloxacin	24	$187	$8
Omeprazole	17	$107	$6
Ibuprofen	12	$85	$7
Simvastatin	14	$77	$5
Carisoprodol	13	$76	$6
Citalopram Hbr	12	$72	$6

Money from drug and device companies

$342 in 2025

Sort by

Industry payments by year

2025	6	11	None	$342
2024	10	24	None	$639
2023	6	14	None	$246
2022	7	21	None	$582
2021	6	19	None	$469
2020	6	16	None	$301
2019	10	17	None	$357

Paid work is consulting, speaking, honoraria and royalties, as opposed to meals and travel.

A payment is not proof that care is biased.

Sort by

Payments by company

Stryker	Variax	$137	4 payments Meals for Easyfuse · 2025-12-09 · $11 Meals for Viaflow · 2025-12-09 · $5 Meals for Easyfuse · 2025-08-14 · $21 Meals for Variax · 2025-06-25 · $100
Smith+Nephew	Stravix	$90	2 payments Meals for Stravix · 2025-06-25 · $48 Meals for Grafix Pl · 2025-01-30 · $42
Integra LifeSciences	Integra	$57	2 payments Meals for Integra · 2025-12-23 · $17 Meals for Integra · 2025-06-10 · $40
Koya Medical	Koya Medical	$26	1 payment Meals for Koya Medical · 2025-03-24 · $26
MIMEDX Group	None	$17	1 payment Meals · 2025-03-20 · $17
Tactile Systems Technology	Flexitouch Plus	$15	1 payment Meals for Flexitouch Plus · 2025-09-24 · $15

See all 11 published payments

Sort by

Every published payment

Integra LifeSciences	Meals · 2025-12-23	Integra	$17
Stryker	Meals · 2025-12-09	Easyfuse	$11
Stryker	Meals · 2025-12-09	Viaflow	$5
Tactile Systems Technology	Meals · 2025-09-24	Flexitouch Plus	$15
Stryker	Meals · 2025-08-14	Easyfuse	$21
Stryker	Meals · 2025-06-25	Variax	$100
Smith+Nephew	Meals · 2025-06-25	Stravix	$48
Integra LifeSciences	Meals · 2025-06-10	Integra	$40
Koya Medical	Meals · 2025-03-24	Koya Medical	$26
MIMEDX Group	Meals · 2025-03-20	None	$17
Smith+Nephew	Meals · 2025-01-30	Grafix Pl	$42

See earlier years (2024, 2023, 2022, 2021, 2020, 2019)

2024: $639

Sort by

Payments by company in 2024

Stryker	Prostep	$156	1 payment Meals for Prostep · 2024-06-19 · $156
Tactile Systems Technology	Flexitouch Plus	$133	7 payments Meals for Flexitouch Plus · 2024-08-28 · $22 Meals for Flexitouch Plus · 2024-05-24 · $18 Meals for Flexitouch Plus · 2024-04-19 · $14 Meals for Flexitouch Plus · 2024-04-08 · $24 Meals for Flexitouch Plus · 2024-03-22 · $13 Meals for Flexitouch Plus · 2024-01-19 · $24 Meals for Flexitouch Plus · 2024-01-18 · $19
Smith+Nephew	Renasys Touch	$95	3 payments Meals for Renasys Touch · 2024-07-10 · $48 Meals for Evos · 2024-06-26 · $16 Meals for Grafix Pl · 2024-06-12 · $31
PolyNovo North America	Novosorb Btm	$68	4 payments Meals for Novosorb Btm · 2024-10-17 · $17 Meals for Novosorb Btm · 2024-04-22 · $15 Meals for Novosorb Btm · 2024-02-26 · $14 Meals for Novosorb Btm · 2024-01-29 · $21
Organogenesis	None	$53	2 payments Meals · 2024-09-10 · $28 Meals · 2024-04-17 · $25
Integra LifeSciences	Integra	$45	3 payments Meals for Integra · 2024-12-11 · $17 Meals for Integra · 2024-08-13 · $14 Meals for Integra · 2024-04-30 · $15
Bioventus	Exogen Ultrasound Bone Healing System	$28	1 payment Meals for Exogen Ultrasound Bone Healing System · 2024-11-20 · $28
Paratek Pharmaceuticals	Nuzyra	$22	1 payment Meals for Nuzyra · 2024-01-24 · $22
DePuy Synthes Sales	None	$20	1 payment Meals · 2024-08-01 · $20
Abbott Laboratories	Eterna	$19	1 payment Meals for Eterna · 2024-05-16 · $19

2023: $246

Sort by

Payments by company in 2023

Tactile Systems Technology	Flexitouch Plus	$75	5 payments Meals for Flexitouch Plus · 2023-12-08 · $14 Meals for Flexitouch Plus · 2023-10-13 · $13 Meals for Flexitouch Plus · 2023-09-18 · $17 Meals for Flexitouch Plus · 2023-08-16 · $16 Meals for Flexitouch Plus · 2023-07-26 · $16
Integra LifeSciences	Integra	$65	3 payments Meals for Integra · 2023-12-08 · $30 Meals for Integra · 2023-10-09 · $15 Meals for Integra · 2023-03-23 · $20
Biotissue Holdings	Neox	$40	2 payments Meals for Neox · 2023-02-20 · $18 Meals for Neox · 2023-02-20 · $21
Smith+Nephew	Renasys Touch	$32	2 payments Meals for Renasys Go V2 Home · 2023-12-20 · $15 Meals for Renasys Touch · 2023-07-12 · $17
DePuy Synthes Sales	Motoband	$18	1 payment Meals for Motoband · 2023-07-05 · $18
Paratek Pharmaceuticals	Nuzyra	$17	1 payment Meals for Nuzyra · 2023-01-24 · $17

2022: $582

Sort by

Payments by company in 2022

Smith+Nephew	Collagenase Santyl	$144	7 payments Meals for Collagenase Santyl · 2022-12-12 · $30 Meals for Collagenase Santyl · 2022-10-20 · $35 Meals for Pico 7 · 2022-10-06 · $14 Meals for Stravix Mesh · 2022-08-01 · $24 Meals for Pico 7 · 2022-04-07 · $6 Meals for Stravix · 2022-02-23 · $21 Meals for Collagenase Santyl · 2022-02-11 · $16
Organogenesis	Puraply	$142	3 payments Meals for Puraply · 2022-04-28 · $49 Meals for Puraply · 2022-02-18 · $49 Meals for Puraply · 2022-02-09 · $45
Integra LifeSciences	Integra	$109	4 payments Meals for Integra · 2022-12-30 · $29 Meals for Integra · 2022-10-05 · $23 Meals for Integra · 2022-06-08 · $31 Meals for Integra · 2022-03-23 · $25
Saxum Surgical	None	$66	1 payment Meals · 2022-10-18 · $66
BioTissue Holdings	Neox	$51	2 payments Meals for Neox · 2022-06-01 · $28 Meals for Neox · 2022-03-22 · $24
Kci USA	Activ.A.C.	$43	2 payments Meals for Activ.A.C. · 2022-08-10 · $22 Meals for V.A.C. Veraflo · 2022-07-17 · $21
Sebela Pharmaceuticals	Naftin	$26	2 payments Meals for Naftin · 2022-12-21 · $13 Meals for Naftin · 2022-09-15 · $13

2021: $469

Sort by

Payments by company in 2021

Ivoclar Vivadent	None	$156	1 payment Meals · 2021-11-30 · $156
Smith+Nephew	Stravix	$129	9 payments Meals for Pico7 · 2021-10-08 · $14 Meals for Stravix · 2021-09-16 · $14 Meals for Stravix · 2021-08-16 · $9 Meals for Stravix · 2021-07-10 · $15 Meals for Collagenase Santyl · 2021-07-07 · $39 Meals for Stravix · 2021-07-01 · $16 Meals for Renasys Go · 2021-06-08 · $12 Meals for Pico7 · 2021-04-07 · $2 Meals for Pico7 · 2021-02-16 · $9
Integra LifeSciences	Integra Meshed Bilayer Wound Matrix	$81	4 payments Meals for Integra Meshed Bilayer Wound Matrix · 2021-12-23 · $12 Meals for Integra Meshed Bilayer Wound Matrix · 2021-10-20 · $20 Meals for Integra Meshed Bilayer Wound Matrix · 2021-07-14 · $28 Meals for Integra Meshed Bilayer Wound Matrix · 2021-03-02 · $21
Tissuetech	Neox	$60	3 payments Meals for Neox · 2021-11-04 · $17 Meals for Neox · 2021-11-04 · $18 Meals for Neox · 2021-02-24 · $25
Acera Surgical	Restrata Wound Matrix	$26	1 payment Meals for Restrata Wound Matrix · 2021-08-11 · $26
Nabriva Therapeutics plc	Sivextro	$17	1 payment Meals for Sivextro · 2021-08-19 · $17

2020: $301

Sort by

Payments by company in 2020

Smith+Nephew	Santyl	$155	10 payments Meals for Stravix · 2020-12-24 · $3 Meals for Santyl · 2020-12-10 · $52 Meals for Grafix Pl · 2020-09-22 · $25 Meals for Stravix · 2020-09-11 · $8 Meals for Stravix · 2020-08-11 · $4 Meals for Renasys · 2020-08-05 · $9 Meals for Stravix · 2020-06-29 · $7 Meals for Santyl · 2020-03-24 · $18 Meals for Grafix Pl · 2020-03-03 · $10 Meals for Grafix Pl · 2020-01-09 · $20
Stryker	Hydroset	$44	1 payment Meals for Hydroset · 2020-02-18 · $44
Wright Medical Technology	Bioskin	$37	1 payment Meals for Bioskin · 2020-02-23 · $37
Integra LifeSciences	Omnigraft	$28	2 payments Meals for Omnigraft · 2020-08-12 · $14 Meals for Bilayer Wound Matrix (Bwm) · 2020-01-28 · $14
Zyla Life Sciences	Sprix	$19	1 payment Meals for Sprix · 2020-03-12 · $19
Ermi	None	$18	1 payment Meals · 2020-02-17 · $18

2019: $357

Sort by

Payments by company in 2019

Smith+Nephew	Santyl	$77	3 payments Meals for Stravix · 2019-12-17 · $20 Meals for Santyl · 2019-08-20 · $33 Meals for Santyl · 2019-04-22 · $24
Horizon Therapeutics plc	Krystexxa	$55	4 payments Meals for Krystexxa · 2019-03-27 · $14 Meals for Krystexxa · 2019-02-06 · $13 Meals for Krystexxa · 2019-01-16 · $13 Meals for Krystexxa · 2019-01-02 · $15
Ermi	None	$52	1 payment Meals · 2019-04-02 · $52
In2Bones USA	Neospan	$46	1 payment Meals for Neospan · 2019-09-20 · $46
Integra LifeSciences	Salto Talaris Total Ankle Prosthesis	$38	1 payment Meals for Salto Talaris Total Ankle Prosthesis · 2019-10-15 · $38
Stryker	Hydroset	$20	1 payment Meals for Hydroset · 2019-08-29 · $20
Terumo BCT	Bone Marrow Aspirate Concentrate System	$19	1 payment Meals for Bone Marrow Aspirate Concentrate System · 2019-03-14 · $19
Wright Medical Technology	Cartiva	$18	1 payment Meals for Cartiva · 2019-01-18 · $18
Arthrosurface	Hemicap Mtp Resurfacing	$16	1 payment Meals for Hemicap Mtp Resurfacing · 2019-09-10 · $16
Tactile Systems Technology	Flexitouch	$15	1 payment Meals for Flexitouch · 2019-10-29 · $15

Checkups this office reported

Medicare did not publish checkup rates for this clinician.

Medicare’s overall office score: 0.0 / 100; Scores the office’s reporting and systems. It is not a grade for how the doctor treats you.

Professional record

NPI: 1043265549
Licence: CA E4157
Trained: California School of Podiatric Medicine, 1997 · 29 years ago
Group: Kim Foot and Ankle Medical Centers of Long Beach
Gender: Male

More record details

Sole proprietor: No
Taxonomy: Federal specialty code 213ES0000X (213ES0000X)
Mailing address: 701 E 28th St, Suite 111, Long Beach, CA, 90806
NPI first listed: 2006-05-23
NPI last updated: 2013-09-26

This is when the NPI record was last certified, not a medical board exam.