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NPI 1467460980 · Ashland, WI · Family Medicine Physician
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Andrew Matheus is a family medicine physician provider located in Ashland, Wisconsin. This profile covers 14 Medicare and 8 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Andrew Matheus |
| Address | 1001 Main St W |
| City | Ashland |
| State | WI |
| ZIP | 54806 |
| Taxonomy | Family Medicine Physician |
| NPI Enumerated | August 3, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $160.4K |
| Medicare | $60.4K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
14 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 300 | $80 | $24K |
| 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… | 360 | $60 | $19.7K |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 90 | $120 | $11.3K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 260 | $10 | $2.1K |
| G0008 | Administration of influenza virus vaccine | 30 | $30 | $950 |
| 90688 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It uses split virus technology and is given as a 0.5 mL dose. | 30 | $20 | $660 |
| 69210 | The provider uses an instrument such as a curette, vacuum evacuation, or forceps to remove entrapped wax from a patient's external auditory canal. | 20 | $30 | $640 |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | 20 | $20 | $290 |
| 93000 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 30 | $10 | $270 |
| 96372 | A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician… | 30 | $10 | $260 |
Showing 1–10 of 14
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
Full comparison — all codes billed, vs. state median
14 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 99214 | 918 | 9,800 | 80 | $70 | $9.2K |
| G0439 | 699 | 2,350 | 50 | $120 | $9.1K |
| 99213 | 267 | 9,380 | 60 | $50 | $4.7K |
| G0103 | 78 | 100 | 30 | $20 | $4.5K |
| G0008 | 1,463 | 2,540 | 40 | $30 | $2.4K |
| 85025 | 744 | 870 | 30 | $10 | $2.4K |
| 36415 | 298 | 2,300 | 70 | $10 | $2.3K |
| 69210 | 138 | 210 | 40 | $20 | $1.9K |
| 96372 | 183 | 260 | 40 | $10 | $820 |
| 90688 | 6 | 10 | 20 | $20 | $690 |
Showing 1–10 of 14
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
8 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 2,750 | $30 | $82.6K |
| 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… | 1,640 | $50 | $74K |
| 99000 | Use this code for the in office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory. | 710 | $1 | $2.1K |
| 0011A | N/A | 10 | $40 | $490 |
| 0001A | N/A | 10 | $40 | $460 |
| 87880 | The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab. | 20 | $10 | $270 |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 470 | $0 | $0 |
| 90471 | In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route. | 10 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Wisconsin median
8 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 437 | 1,630 | 270 | $40 | $205.3K |
| 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… | 380 | 1,760 | 250 | $40 | $173.2K |
| 87880 | The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab. | 253 | 290 | 240 | $20 | $20K |
| 99000 | Use this code for the in office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory. | 99 | 260 | 320 | $1 | $13K |
| 0001A | N/A | 441 | 460 | 120 | $30 | $7K |
| 0011A | N/A | 321 | 340 | 70 | $30 | $3K |
| 90471 | In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route. | 262 | 270 | 80 | $1 | $3K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 244 | 420 | 900 | $1 | $1.7K |
Other providers in the same ZIP code as Andrew Matheus, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Memorial Medical Center Inc | WI | Critical Access Hospital | $0 | $22.6M |
| County Of Ashland | WI | Public Health or Welfare Agency | $9.1K | $7.5M |
| Avanti Home Health Services, LLC | WI | Home Health Agency | $0 | $3.3M |
| City Of Ashland | WI | Land Ambulance | $286K | $418.3K |
| Kim Ogle | WI | Internal Medicine Physician | $211.8K | $0 |
| Walgreen Co | WI | Pharmacy | $131.8K | $50.7K |
| Brianne Sable | WI | Physician Assistant | $121.5K | $0 |
| Matthew Horning | WI | Family Medicine Physician | $88K | $0 |
| Katie Smith | WI | Physical Therapist | $64.1K | $0 |
| Stephen Smalley | WI | Cardiovascular Disease Physician | $63.1K | $0 |
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