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 North Carolina for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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 Nelson (NPI 1417953654)

Field	Value
Entity Type	Individual
Organization	Mark Nelson
Address	750 Highland Oaks Dr Ste 100
City	Winston Salem
State	NC
ZIP	27103
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	June 22, 2005

Payer Source	Total Paid
Medicare	$1.1M
Medicaid	$0

Medicare: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2777	Injection, faricimab‑svoa, 0.1 mg	21,480	$30	$622.9K
J0178	Injection, aflibercept, 1 mg	300	$680	$199.8K
J2778	Injection, ranibizumab, 0.1 mg	610	$170	$103.6K
J3396	Injection, verteporfin, 0.1 mg	6,750	$10	$60.8K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	650	$80	$50.4K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	1,490	$30	$40.2K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	680	$40	$24.6K
99213	The 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…	220	$70	$14.7K
92242	The provider injects two different special dyes into one or both eyes that cause the blood vessels to stand out in photographic images timed so that multiple frames are taken in rapid succession. He…	50	$190	$9.7K
67221	In this procedure, the provider treats a localized cancerous focus within the middle layer of one eye by infusing a special drug, which he can activate by application of a laser beam.	50	$190	$8.7K

Showing 1–10 of 14

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. North Carolina Distribution

Mark Nelson — 2 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. state median

14 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	75	100	950	$690	$881K
J2777	24	70	12,990	$30	$503.7K
J2778	24	50	620	$180	$202.2K
67028	67	120	780	$90	$80K
J3396	1	10	6,750	$10	$59K
92242	3	10	40	$190	$12.1K
92235	61	70	60	$100	$8.7K
92134	42	790	70	$30	$7.5K
99213	2,604	16,320	70	$50	$7.1K
67221	1	10	40	$180	$6.6K

Showing 1–10 of 14

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wake Forest University Health Sciences	NC	Multi-Specialty Clinic/Center	$0	$188.2M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Wake Forest University Health Sciences	NC	Multi-Specialty Clinic/Center	$0	$11.9M
Afc Urgent Care And Family Care Of Wnc, PLLC	NC	Urgent Care Clinic/Center	$0	$9.4M
Keegan Harkins	NE	Ophthalmology Physician	$3.5M	$0
Jedediah Mcclintic	PA	Ophthalmology Physician	$3.2M	$18.9K
Claudia Hooten	TX	Retina Specialist (Ophthalmology) Physician	$2.6M	$0
Donald Vile	VA	Hematology & Oncology Physician	$1.4M	$0
Omar Sangueza	NC	Dermatopathology (Pathology) Physician	$810.1K	$0
Brian Zamora	NC	Retina Specialist (Ophthalmology) Physician	$793.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Forsyth Memorial Hospital, Inc.	NC	General Acute Care Hospital	$0	$40.9M
Bayada Home Health Care, Inc.	NC	Home Health Agency	$0	$39.5M
Bayada Home Health Care, Inc.	NC	Developmental Disabilities Clinic/Center	$0	$35.4M
Bayada Home Health Care, Inc.	NC	Home Health Agency	$0	$34.4M
Rafael Rivera, Jr., Dds, PLLC	NC	Dentist	$0	$22.1M
Bayada Home Health Care, Inc.	NC	Home Health Agency	$0	$21M
A Bridge To Achievement Nc, LLC	NC	Community/Behavioral Health Agency	$0	$15.6M
Nevaeh & Company LLC	NC	Customized Equipment (DME)	$0	$12.1M
Speechcenter LLC, D/b/a Sidekick Therapy Partners	NC	Speech-Language Pathologist	$0	$10.8M
Champion Family Healthcare Services, LLC	NC	Home Health Agency	$0	$9.9M

Mark Nelson — Billing Profile & Reimbursement Data

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Mark Nelson — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References