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    v1.0.28
    OpenPayerNPI Medicare & MedicaidDennis Wales
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    Dennis Wales — Billing Profile & Reimbursement Data

    NPI 1376650408 · Durango, CO · Family Medicine Physician

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    Dennis Wales is a family medicine physician provider located in Durango, Colorado. This profile covers 19 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
    OrganizationDennis Wales
    Address810 E 3rd St Unit 201
    CityDurango
    StateCO
    ZIP81301
    TaxonomyFamily Medicine Physician
    NPI EnumeratedAugust 24, 2006

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

    Payer SourceTotal Paid
    Medicare$105.9K
    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.

    19 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit310$100$30.1K
    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…420$70$29.1K
    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…210$60$12.1K
    90677This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 20–valent vaccine, protecting against 20 strains of the…40$280$12.1K
    90694This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is an inactivated, adjuvanted, preservative–free vaccine given as a 0.5 mL…50$80$4.1K
    91320This code represents a SARS–CoV–2 vaccine product (tris–sucrose formulation) administered by intramuscular injection to reduce the patient’s risk of contracting COVID–19. The dosage is 30 mcg/0.3 mL.30$130$3.8K
    99495The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires at least moderate medical decision making,…30$90$2.7K
    G0402Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment20$160$2.5K
    G0438Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit20$140$2.2K
    G0008Administration of influenza virus vaccine60$30$1.8K

    Showing 1–10 of 19

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    19 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    9132037363040$120$42.1K
    9048060188080$40$16.1K
    906778092020$270$15.4K
    9069419170030$70$14.8K
    992145378,16080$80$11.3K
    G00086971,83040$30$7.4K
    G0439411,90050$90$7K
    992131,0467,20070$60$6.6K
    992031,8652,65030$70$3.1K
    G043814425020$140$3K

    Showing 1–10 of 19

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Kirk MitchellCOGeriatric Medicine (Internal Medicine) Physician$27.1M$1M
    Shahid JaveryCOInternal Medicine Physician$11.4M$0
    Clayton LabaumeCOSurgical Physician Assistant$1.4M$0
    Nicole DaveyTXRheumatology Physician$1.4M$0
    Misbah ZmilyNMInternal Medicine Physician$609.4K$703K
    Justin HoumanCAUrology Physician$696.5K$0
    Samir HadiNVVascular & Interventional Radiology Physician$642.2K$0
    Marie WeeksCORadiation Oncology Physician$355.2K$0
    Kimberly WagnerCONeurology Physician$353.4K$0
    Kristina SanchezNMFamily Medicine Physician$310K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Southwest Colorado Mental Health Center, IncCOMental Health Clinic/Center (Including Community Mental Health Center)$0$18.2M
    Catholic Health Initiatives ColoradoCOGeneral Acute Care Hospital$0$6M
    Pediatric Partners Of The SouthwestCOPediatrics Physician$0$5.8M
    Southwest Colorado Mental Health Center, IncCOFederally Qualified Health Center (FQHC)$0$4.5M
    Southwest Colorado Mental Health Center, IncCOFederally Qualified Health Center (FQHC)$0$4.3M
    Nicholas HugentoblerCOFoot & Ankle Surgery Podiatrist$1.9M$0
    Kyle PiwonkaCORetina Specialist (Ophthalmology) Physician$1.7M$0
    Sano Vita IncCOCommunity/Retail Pharmacy$86.6K$359.1K
    Joshua ZastrockyCOOphthalmology Physician$352.5K$0
    Jonathan ClarkCORadiation Oncology Physician$340.9K$0

    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. Colorado Distribution
    Dennis Wales — 1 of 19 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Colorado