In 2006, Medicare inappropriately paid a total net $178 million (out of $466 million) for chiropractic claims for services that were maintenance therapy ($157 million), mis-coded ($11 million), or undocumented ($46 million). Another study indicated that 83% of all chiropractic claims failed to meet one or more of the documentation requirements. Of the 76% of records that reviewers indicated contained some form of treatment plan, 43% lacked treatment goals, 17% lacked objective measures, and 15% lacked the recommended level of care. A medical reviewer indicated, “in my twenty-nine years of practice, I rarely saw documentation of a plan which included frequency, duration, goals and objective measures. While these guidelines are in the Medicare manual, they apparently have not been incorporated into the profession.”