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    OpenPayerNPI Medicare & MedicaidGilbert Falcon
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    Gilbert Falcon — Billing Profile & Reimbursement Data

    NPI 1427288018 · Belcourt, ND · Family Medicine Physician

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    Gilbert Falcon is a family medicine physician provider located in Belcourt, North Dakota. This profile covers 34 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
    OrganizationGilbert Falcon
    Address1300 Hospital Loop
    CityBelcourt
    StateND
    ZIP58316
    TaxonomyFamily Medicine Physician
    NPI EnumeratedJuly 17, 2009

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

    Payer SourceTotal Paid
    Medicare$49.4K
    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.

    34 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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…260$50$13.4K
    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…130$80$9.9K
    36415In this procedure, the provider inserts a needle into a vein to collect a blood sample.580$10$4.6K
    P9604Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge370$10$4K
    80053The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.270$10$2.6K
    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…250$10$2K
    80061The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.130$10$1.7K
    84443The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…100$20$1.7K
    83037The analyst performs a test using a drop of blood obtained by fingerstick or venipuncture from the patient to rapidly measure the level of glycosylated hemoglobin, HgbA1c. The analyst uses a device…130$10$1.1K
    80048The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…110$10$870

    Showing 1–10 of 34

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 34 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    34 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    8230691050$30$27.1K
    992145881,47090$60$10.4K
    8260772020$10$9K
    84443146060$20$7.9K
    8355091020$10$6.1K
    992131811,49080$50$5.8K
    8272882020$10$5.5K
    84439162060$10$5.1K
    9066218319040$70$5.1K
    87077610480$10$4.9K

    Showing 1–10 of 34

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Quentin N Burdick Comprehensive Health Care FacilityNDRural Acute Care Hospital$0$22.2M
    University Of North DakotaNDFamily Medicine Physician$0$1.4M
    University Of North DakotaNDFamily Medicine Physician$0$523.3K
    Travis PetreeNDDiagnostic Radiology Physician$275.7K$0
    Brian JohnsonNDDiagnostic Radiology Physician$153.7K$0
    Peter BrittGAVascular & Interventional Radiology Physician$137.5K$0
    Farzodd HanjaniNDDiagnostic Radiology Physician$137.4K$0
    Thompson KambaNDDiagnostic Radiology Physician$122.5K$0
    Nana AppiawiahCODiagnostic Radiology Physician$110.4K$0
    Wesley EllisonNDAnatomic Pathology Physician$99.4K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Trinity HospitalsNDEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center$0$754.6K
    Ruth HawkinsNDDentist$0$254.8K
    Turlte Mountain Maternal Child Health ProgramNDCase Management Agency$0$54.7K
    Jennifer KeplinNDPsychiatric/Mental Health Nurse Practitioner$0$53.2K
    Jona PeltierNDClinical Social Worker$0$51.2K
    Tami Jollie-trottier, Phd, PLLCNDClinical Psychologist$0$47.9K
    Turtle Mountain Recovery CenterNDSubstance Use Disorder Rehabilitation Clinic/Center$0$41.3K
    Belcourt Ihs HospitalNDIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy$0$24.3K
    Turtle Mountain Elite Physical TherapyNDPhysical Therapist$0$3.3K

    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. North Dakota Distribution
    Gilbert Falcon — 1 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — North Dakota