MAINOR R. ANTILLON-GALDAMEZ, M.D.

NPI 1215962873, individual, Eau Claire, WI, Internal Medicine, Gastroenterology

Evidence tier

documented action, then payment

Listed on the CA Medicaid exclusion list since January 18, 2023.
Medicaid still paid claims in 12 later months, $69,890 in total.

score 95 of 100, rank 162, $70K at stake

Paid after the action

Months in which Medicaid paid claims for this provider after a public action that should have triggered a screening check. This is a record of payments, not a determination that they were improper.

list	identity check	action date	window closed	months paid after	first	last	paid after	12 months before
CA Medicaid exclusion list ca medi-cal suspended & ineligible provider list (july 2026)	Exact NPI, name verified	Jan 18, 2023	still open	12	May 2023	Aug 2024	$70K	$0

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	MAINOR R. ANTILLON-GALDAMEZ, M.D. (also MAINOR ANTILLON)
Type	Individual
Status	Active
NPI issued	July 12, 2006, last updated February 3, 2023
Practice location	1400 BELLINGER ST, Eau Claire, WI 54703, 715-838-5222
Mailing address	PO BOX 1510, Eau Claire, WI 54702-1510
Specialties	Internal Medicine, Gastroenterology (207RG0100X, license 4301106568 MI) Internal Medicine, Gastroenterology (207RG0100X, primary, license 67158 WI)

Procedures billed

The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.

Medicaid, largest codes

code	what it is	paid	share	per patient-month	typical	rank among providers
45378	Diagnostic exam of large bowel using a flexible endoscope	$60K	86%	$187	$248 (top 5% from $867)	35th percentile
45380	Biopsy of large bowel using a flexible endoscope	$9K	13%	$122	$227 (top 5% from $770)	too few months to rank
43239	Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	$966	1%	$40	$157 (top 5% from $606)	too few months to rank

Medicare Part B 2024, largest codes

code	what it is	services	beneficiaries	paid	submitted per service	allowed per service	charge to allowed	usual for this code
45380	Biopsy of large bowel using a flexible endoscope	19	19	$3K	$921	$176	5.2x	8.2x (90th percentile 18.5x)
45378	Diagnostic exam of large bowel using a flexible endoscope	15	15	$2K	$873	$173	5.0x	5.0x (90th percentile 9.6x)
43239	Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	18	18	$1K	$597	$93	6.4x	8.5x (90th percentile 17.6x)

A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.

In this area

6 providers in Eau Claire County, WI carry an indicator in the public record, with $1.8M at stake between them. The most common is part of a provider network, on 4 of them, followed by more hours than a day holds on 2.

tier	provider	at stake	why
3	WEST EAU CLAIRE REHABILITATION AND NURSING CENTER LLC Eau Claire, WI, ranked 1567	$8K	Part of provider network D1-00087, ranked 87 nationally.
3	GRACE LUTHERAN FOUNDATION, INC. Altoona, WI, ranked 1632	$2K	Part of provider network D1-00095, ranked 95 nationally.
3	MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC. Eau Claire, WI, ranked 1836	$0	Part of provider network D1-00125, ranked 125 nationally.
3	SOUTH EAU CLAIRE REHABILITATION AND NURSING CENTER LLC Eau Claire, WI, ranked 7031	$0	Part of provider network D1-00087, ranked 87 nationally.
5	PAUL CAILLIER Eau Claire, WI, ranked 10547	$1.6M	90% of Medicaid dollars are on codes with a history of abuse.
5	KATHERINE GLEASON Eau Claire, WI, ranked 10645	$145K	70% of Medicaid dollars are on codes with a history of abuse.

Recent enforcement in WI

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJChargedJun 25, 2026

Federal Charges Announced in Multi-Million Dollar Medicaid Fraud Scheme and Prescription Drug Diversion Conspiracy; Announcement Made as Part of Justice Department’s National Health Care Fraud Takedown

Cooper submitted over $5.8 million in false claims to Wisconsin Medicaid for prenatal care coordination services that beneficiaries never received and used another person's means of identification, while Jones conspired to distribute controlled substances outside the usual course of professional practice.

DOJCivil settlementApr 17, 2026

Appleton Clinic to Pay Over $380,000 to Resolve False Claims Act Allegations Relating to the Marketing and Use of Electric Stimulation Devices

Apple Medical Clinic and its principal caused the submission of false claims to Medicare for electrical muscle stimulation, vitamin injections, and other related services that were not medically reasonable or necessary, and marketed the Sanexas device outside its FDA clearance and contrary to coverage determinations.

DOJSentencedMar 23, 2026

Owner of Now-Closed Milwaukee Prenatal Care Coordination Company Sentenced to 60 Months’ Imprisonment for Healthcare Fraud Scheme

Jackson offered women kickbacks in exchange for their Medicaid numbers and falsely billed Wisconsin Medicaid for prenatal care coordination services, almost always at the monthly maximum, when she and her employees provided few to no covered services.

DOJCivil settlementMar 5, 2026

Waukesha Medical Equipment Company Agrees to Pay Nearly $7 Million to Resolve Allegations of False Billings to Federal Healthcare Programs

From 2019 through 2024, Kinex provided patients covered by federal programs with medical braces the patients did not need and billed Medicare, TRICARE, FEHBP, and OWCP as if the braces had been necessary, inducing patients to accept them by waiving co-pays and giving free equipment.

DOJSentencedFeb 3, 2026

Delafield Man Sentenced to 18 Months’ Imprisonment for Conspiracy to Pay Healthcare Kickbacks

Johnson paid kickbacks to companies purporting to provide marketing services in exchange for signed prescriptions and doctors' orders for durable medical equipment that his company Kestrel Medical submitted to Medicare.

Referral packet

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Ask this case

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