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 Harris (NPI 1437157872)

Field	Value
Entity Type	Individual
Organization	Mark Harris
Address	1710 S. 17th St.
City	Wilmington
State	NC
ZIP	28401
Taxonomy	Rheumatology Physician
NPI Enumerated	July 11, 2005

Payer Source	Total Paid
Medicare	$3M
Medicaid	$0

Key Findings

MARK HARRIS is a Rheumatology Physician in WILMINGTON, NC with lifetime Medicare revenue of $3M and no Medicaid billing on file; his NPI has been enumerated since 2005-07-11 (~21 years ago), indicating a long-tenured outpatient practice. The absence of any Medicaid claims makes this effectively a single-payer Medicare revenue profile for the data available.

Revenue is highly concentrated in a small set of biologic/infusion codes: the precomputed top 3 Medicare codes by revenue account for 74.9% of this provider's total Medicare revenue. Those top three contributors are J0129 ($1.3M, 44.3%), J3262 ($572.8K, 19.5%), and J1602 ($325K, 11.1%), so a large majority of billed Medicare dollars flow through a trio of high-cost injectable/infusion drugs.

The code mix strongly points to an infusion-centric rheumatology practice: J0129 (abatacept), J3262 (tocilizumab), J1602 (golimumab), and J1745 (infliximab) are the dominant revenue drivers and are all parenteral biologic therapies typically given under physician supervision. The presence of high-volume infusion codes alongside chemotherapy administration code 96413 ($106.8K, 3.6%) suggests the practice has capacity and workflows for IV drug administration rather than being limited to office visits or self-administered biologics.

MARK HARRIS is a national outlier on several specific codes: J0129 ranks #19 of 1221 providers nationally (99th percentile; extreme outlier) and 96413 ranks #54 of 7514 providers nationally (99th percentile; extreme outlier), indicating extraordinarily high national volume for those administration codes relative to peers. J3262 ranks #37 of 618 providers nationally (94th percentile; notably above typical national volume), while J1602 ranks #135 of 1041 (87th percentile; typical, unremarkable volume), so the provider’s dominance is code-specific rather than uniform across all biologics.

Office evaluation-and-management activity is also elevated: 99214 generated $95.2K (3.2%) and ranks #9390 of 479517 providers nationally (98th percentile; extreme outlier), reflecting substantial established patient visit volume in addition to infusion services. At the same time, many routine lab and imaging codes (for example 85025, 80076, 86140) appear with typical, unremarkable volumes or percentile placements, consistent with comprehensive outpatient rheumatology management rather than an expanded multi-specialty service line.

Payer-mix and operational risk are concentrated: with $3M in Medicare revenue and no Medicaid billing on file, the practice is heavily dependent on Medicare reimbursement and utilization patterns. Because the top three Medicare codes account for 74.9% of Medicare revenue, changes in coverage, reimbursement, or utilization for those specific biologics could have outsized financial impact on the provider.

Competitive positioning in the market is nuanced: nationally the provider is a leading high-volume administrator for select biologics (notably J0129 and J3262) but otherwise shows many code-level volumes that are typical for rheumatology peers. This pattern suggests a niche specialization or business model focused on onsite infusion services and high-volume administration of certain biologics rather than uniformly high volumes across the full scope of rheumatology procedures.

Medicare: Complete Services Breakdown

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

52 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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)	39,400	$30	$1.3M
J3262	Injection, tocilizumab, 1 mg	114,560	$10	$572.8K
J1602	Injection, golimumab, 1 mg, for intravenous use	32,500	$10	$325K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	5,710	$30	$148.5K
J0717	Injection, certolizumab pegol, 1 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)	31,600	$1	$126.4K
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…	1,090	$100	$106.8K
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…	1,080	$90	$95.2K
J0897	Injection, denosumab, 1 mg	3,840	$20	$69.1K
Q5104	Injection, infliximab-abda, biosimilar, (renflexis), 10 mg	2,300	$30	$69K
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.	200	$100	$19.5K

Showing 1–10 of 52

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 52 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. North Carolina Distribution

Mark Harris — 8 of 25 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

52 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	1	70	9,530	$30	$393.2K
J3262	4	40	37,160	$1	$224.8K
J0717	23	40	37,400	$1	$178.8K
J1602	10	70	11,900	$10	$175.9K
J1745	23	80	4,110	$30	$117.3K
Q5104	8	10	2,860	$30	$101.3K
86235	5	40	160	$20	$70.1K
J0897	116	430	2,100	$20	$63.9K
83970	37	300	50	$40	$23K
82306	75	870	50	$30	$20.2K

Showing 1–10 of 52

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Daniel Delo	NC	Rheumatology Physician	$2.8M	$0
Joseph Shanahan	NC	Rheumatology Physician	$1.9M	$0
Gregory Borstad	NC	Rheumatology Physician	$1.6M	$0
John Herion	SC	Internal Medicine Physician	$1.1M	$0
Wendy Simmons	NC	Rheumatology Physician	$847.7K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Novant Health New Hanover Regional Medical Center LLC	NC	General Acute Care Hospital	$0	$57.5M
New Hanover Regional Medical Center	NC	General Acute Care Hospital	$0	$23.7M
Access Family Services	NC	Community/Behavioral Health Agency	$0	$15.3M
Care Providers Of Wilmington	NC	Home Health Agency	$0	$10M
Wilmington Health PLLC	NC	Pediatrics Physician	$0	$10M
Ecep Ii PA	NC	Emergency Medicine Physician	$0	$9.7M
Novant Health New Hanover Regional Medical Center LLC	NC	Ambulance	$6.1M	$2.7M
Coastal Horizons Center Inc.	NC	Community/Behavioral Health Agency	$0	$8.7M
New Hanover Community Health Center Incorporated	NC	Federally Qualified Health Center (FQHC)	$0	$8.5M
Kidzcare Pediatrics, PC	NC	Pediatrics Physician	$0	$8.2M

Mark Harris — 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