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    v1.0.28
    OpenPayerNPI Medicare & MedicaidMarlon Navarro
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    Marlon Navarro — Billing Profile & Reimbursement Data

    NPI 1295822948 · Eau Claire, WI · Rheumatology Physician

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    Marlon Navarro is a rheumatology physician provider located in Eau Claire, Wisconsin. This profile covers 9 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationMarlon Navarro
    Address2116 Craig Rd
    CityEau Claire
    StateWI
    ZIP54701
    TaxonomyRheumatology Physician
    NPI EnumeratedOctober 6, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$72.3K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    9 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99215The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…390$100$38.9K
    99205The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…140$120$16.2K
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…90$70$5.9K
    G2212Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary…220$20$4.8K
    99204The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…30$100$3.3K
    20610In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…70$30$2K
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…20$40$900
    20605In this procedure, the provider inserts a needle through the skin of a patient and into an intermediate joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may…10$20$290
    85025A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…10$10$90

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    9 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992144,4849,80080$70$9.2K
    99215333,32030$110$6.3K
    992137,8559,38060$50$4.7K
    9920551,07020$140$4K
    992041,1803,39030$100$3.7K
    2061027981040$40$3.1K
    8502584387030$10$2.4K
    G22121219030$20$1.4K
    20605576020$30$890

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Marlon Navarro, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Kunle OnadeWIDermatology Physician$459.1K$0
    Michael FallonWIRadiation Oncology Physician$320K$0
    Peter LeeWIMOHS-Micrographic Surgery Physician$292.3K$0
    Ruslan IvanovFLEmergency Medicine Physician$267.9K$0
    Michael HirshWIUrology Physician$261.5K$0
    Lamar RobinsonFLDiagnostic Radiology Physician$242.1K$10
    James IwakiriWIUrology Physician$224.3K$0
    Mohammad AlaouaWICardiovascular Disease Physician$190.1K$0
    Nathaniel JalilWINephrology Physician$153.5K$0
    Tejas BrahmbhattWIInterventional Cardiology Physician$137.4K$520

    Nearby Providers

    Other providers in the same ZIP code as Marlon Navarro, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    St Croix Hospice LLCWICommunity Based Hospice Care Agency$0$25.2M
    Mchs Hospitals IncWIGeneral Acute Care Hospital$0$12.4M
    Steven KristoWIOrthodontics and Dentofacial Orthopedics Dentistry$0$7.9M
    Mayo Clinic Health System-northwest Wisconsin Region, Inc.WIMulti-Specialty Clinic/Center$0$7.5M
    Milwaukee Health Services System, LLCWIMethadone Clinic$229.3K$5.6M
    Sacred Heart Hospital Of The Hospital Sisters-3rd Order Of St FrancisWIGeneral Acute Care Hospital$0$5.7M
    Sacred Heart Hospital Of The Hospital Sisters- 3rd Order Of St FrancisWIFamily Medicine Physician$0$4.6M
    Mchs Hospitals IncWIClinic/Center$0$4.1M
    Lutheran Social Services Of Wisconsin And Upper Michigan, Inc.WISubstance Abuse Rehabilitation Facility$0$3.9M
    Dedra Davis-wallaceWIPediatric Dentistry$0$3.6M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Wisconsin Distribution
    Marlon Navarro — 2 of 9 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Wisconsin