Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidCarlos Pence
    Ask Trek AI about this page

    Carlos Pence — Billing Profile & Reimbursement Data

    NPI 1477839041 · Sun City, AZ · Physician Assistant

    Customize your policy alerts

    Sign up for Carlos Pence — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Carlos Pence is a physician assistant provider located in Sun City, Arizona. This profile covers 15 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.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationCarlos Pence
    Address10494 W Thunderbird Blvd Ste 102
    CitySun City
    StateAZ
    ZIP85351
    TaxonomyPhysician Assistant
    NPI EnumeratedOctober 27, 2011

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

    Payer SourceTotal Paid
    Medicare$123K
    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.

    15 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…730$60$40.4K
    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…520$80$39.2K
    G0482Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…130$190$23.9K
    80307The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.130$60$7.9K
    20610In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…80$40$3.4K
    20552Trigger point injection, or TPI, is a medical procedure that involves injecting an anesthetic or corticosteroid substance to relieve a trigger point, which is a painful area or knot in a muscle.100$30$3.1K
    99203The provider sees a new 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 provider…30$60$1.6K
    99204The provider sees a new 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 provider…10$90$1.1K
    72100The technician takes 2 or 3 views of the vertebrae in the lumbar region which is the lower part of the spine and the sacrum, the area that connects the spine to the pelvis. Lumbosacral spine X–rays…30$20$780
    J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg740$1$740

    Showing 1–10 of 15

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    15 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    G0482116060$190$27.4K
    992141,35810,410120$80$20.6K
    803074315060$60$11.7K
    992133479,60080$60$9.6K
    992045,2375,79040$110$6.7K
    2061038195060$50$5.4K
    992032,5944,10040$70$4K
    7350258461050$20$2K
    7356251153050$20$1.9K
    7303056761060$20$1.7K

    Showing 1–10 of 15

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Center For Orthopedic Research And Education, LLCAZOrthopaedic Surgery Physician$0$36.4M
    Kelly KrohnAZInternal Medicine Physician$926.3K$0
    Morris HamburgAZAdult Health Nurse Practitioner$913K$0
    Jonathan MarshallNYDiagnostic Radiology Physician$761.9K$4.4K
    Paul SousaAZAdult Reconstructive Orthopaedic Surgery Physician$529.3K$0
    Damon AdamanyAZOrthopaedic Hand Surgery Physician$466.4K$0
    Eric FeldmanAZInterventional Pain Medicine Physician$424.4K$0
    Joshua AbramsAZOrthopaedic Surgery of the Spine Physician$418.9K$0
    Mark CampbellAZOrthopaedic Surgery Physician$342.9K$0
    Steven WernerAZAdult Reconstructive Orthopaedic Surgery Physician$335K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Banner Boswell Medical CenterAZGeneral Acute Care Hospital$0$27M
    Succeeding At Recovery LLCAZSubstance Use Disorder Rehabilitation Clinic/Center$0$18.8M
    Banner Imaging Services LLCAZDiagnostic Radiology Physician$0$12.9M
    S P Gill Md PCAZMedical Specialty Clinic/Center$0$9.5M
    Maxfar, LLCAZHome Health Agency$0$8.9M
    Leading Healthcare, LLCAZHospitalist Physician$0$7M
    Express Urgent Care, PCAZUrgent Care Clinic/Center$0$6.6M
    Barnet Dulaney Perkins Eye Center, PCAZAmbulatory Surgical Clinic/Center$2.8M$1.1M
    Bcc West Valley LLCAZAmbulatory Surgical Clinic/Center$3.5M$0
    Sun City Ophthalmology Asc LLCAZAmbulatory Surgical Clinic/Center$2M$1.2M

    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. Arizona Distribution
    Carlos Pence — 1 of 14 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Arizona