Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Wisconsin for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Wisconsin only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Wisconsin (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Mark Pearson (NPI 1407857048)

Field	Value
Entity Type	Individual
Organization	Mark Pearson
Address	20800 Swenson Dr Ste 175
City	Waukesha
State	WI
ZIP	53186
Taxonomy	Rheumatology Physician
NPI Enumerated	August 4, 2005

Payer Source	Total Paid
Medicare	$972.6K
Medicaid	$0

Key Findings

This provider is effectively a Medicare-only biller: lifetime Medicare revenue is $972.6K and there is no Medicaid billing on file, making the practice highly concentrated on the Medicare payer stream. The provider’s NPI was enumerated 2005-08-04 (~21 years ago), indicating long tenure and an established billing history in the Medicare program.

Revenue is heavily concentrated in a small set of biologic drug codes: the precomputed top 3 Medicare codes account for 78.8% of total Medicare revenue, with J1602 alone representing $504.9K or 50.4% of Medicare revenue. This level of concentration means a small number of high-cost drug administrations drive the majority of reported Medicare receipts.

The code mix is consistent with a rheumatology practice that delivers in-office intravenous biologic therapy: high-revenue HCPCS are J1602, J0129, J3262 and J1745 (golimumab, abatacept, tocilizumab, infliximab), supported by infusion management codes such as 96365, 96413, and add-on 96415. Alongside these infusion codes the presence of E/M code 99214 (490 claims, $80 avg paid/claim, $39.2K revenue) indicates the practice pairs office evaluation with infusion services for established patients.

J1602 is a standout in national comparisons: it ranks #54 of 1041 providers nationally (95th percentile) and is characterized as notably above typical national volume for this code, underlining the provider’s unusually high throughput or focus on golimumab infusion compared with peers. By contrast, J0129 (ranks #881 of 1221, 28th percentile) and J3262 (ranks #485 of 618, 22th percentile) are described as typical, unremarkable volumes, indicating the provider’s dominance is concentrated specifically on J1602 rather than across all biologics.

Operationally, the combination of dominant J1602 revenue ($504.9K) and supporting infusion codes (e.g., 96365 at 315 claims, 90th percentile) suggests the practice maintains infusion capacity, staffed administration, and workflows for IV biologics rather than solely office visits or self-administered therapies. This profile has implications for supply/administration models, contracting with payers or drug vendors, and sensitivity of revenue to changes in utilization or reimbursement for that drug.

The practice also reports high relative use of routine laboratory and venipuncture services, which supports a medically managed infusion model: 36415 ranks #2813 of 86467 providers (97th percentile), 85025 ranks #2311 of 32833 (93th percentile), and several chemistry panels (84450, 84460, 82040, 82565) are at or above the 94th–97th percentiles. These elevated lab percentiles align with ongoing monitoring requirements for rheumatology patients receiving biologic therapies.

While J1602 is a clear national outlier, other codes show a more modest competitive posture: the core infusion-related medical visit code 99214 ranks #50551 of 479517 providers nationally (89th percentile), indicating a substantial established-patient practice, but most non-golimumab biologic codes are at typical volumes (as noted above). This combination positions the provider as a specialized infusion-focused rheumatology practice with a niche leadership position for a specific biologic drug rather than a broadly dominant multi-drug infusion center.

Given the absence of Medicaid activity, payer mix is highly concentrated in Medicare and the provider’s financial performance and contracting leverage will be driven by Medicare reimbursement patterns and utilization of a few high-revenue biologic codes. Analysts should treat this entity as single-payer exposed when modeling revenue sensitivity or evaluating competitive encounters with other infusion providers in the market.

Medicare: Complete Services Breakdown

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

32 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J1602	Injection, golimumab, 1 mg, for intravenous use	45,900	$10	$504.9K
J0129	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	5,180	$30	$175.9K
J3262	Injection, tocilizumab, 1 mg	21,720	$10	$108.6K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	3,340	$30	$86.9K
99214	The 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…	490	$80	$39.2K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	320	$50	$14.2K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	120	$90	$10.8K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	1,040	$10	$8.3K
85025	A 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…	1,020	$10	$8.1K
86481	The lab analyst performs a test to evaluate an antigen response to certain tuberculosis (TB) antibodies by enumerating T cells that produce gamma interferon.	80	$100	$7.8K

Showing 1–10 of 32

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 32 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Wisconsin Distribution

Mark Pearson — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. state median

32 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	12	10	8,170	$30	$286.2K
J1602	2	10	11,900	$10	$206.3K
J3262	8	10	35,280	$1	$191.4K
J1745	12	20	6,060	$30	$168.9K
96413	35	80	110	$90	$12.7K
86235	18	20	110	$20	$10.7K
82784	7	10	240	$10	$10.1K
99214	250	9,800	80	$70	$9.2K
96365	8	90	50	$50	$5.8K
99213	3,316	9,380	60	$50	$4.7K

Showing 1–10 of 32

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Douglas Hempel	WI	Rheumatology Physician	$1.9M	$0
Carly Skamra	WI	Rheumatology Physician	$943.5K	$0
Nicole Jodat	WI	Medical Physician Assistant	$114.1K	$0
Taraneh Mehrani	WI	Rheumatology Physician	$34K	$0
Maggie Weissman	WI	Nurse Practitioner	$23.3K	$0
Juliana Shah	WI	Adult Health Nurse Practitioner	$15.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grace Machi	WI	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$5.5M
Kci Usa, Inc.	WI	Durable Medical Equipment & Medical Supplies	$0	$4.8M
Oak Medical Sc	WI	Internal Medicine Physician	$0	$4M
Waukesha School District	WI	Local Education Agency (LEA)	$0	$3.3M
Lss Aspen Center LLC	WI	Substance Abuse Rehabilitation Facility	$0	$2.9M
Planned Parenthood Of Wisconsin	WI	Ambulatory Family Planning Facility	$0	$2.5M
Lincare Inc.	WI	Durable Medical Equipment & Medical Supplies	$0	$1.6M
Matt Talbot Recovery Services, Inc	WI	Substance Abuse Rehabilitation Facility	$0	$1.3M
Loganathan Elangovan	WI	Nephrology Physician	$642.5K	$0
Aswin Kumar	WI	Diagnostic Radiology Physician	$387K	$100

Mark Pearson — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References