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 & MedicaidMark Carlson
    Ask Trek AI about this page

    Mark Carlson — Billing Profile & Reimbursement Data

    NPI 1609837368 · Sioux City, IA · Internal Medicine Physician

    Customize your policy alerts

    Sign up for Mark Carlson — 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.

    Mark Carlson is a internal medicine physician provider located in Sioux City, Iowa. This profile covers 22 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 / 7

    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
    OrganizationMark Carlson
    Address1605 Douglas St
    CitySioux City
    StateIA
    ZIP51105
    TaxonomyInternal Medicine Physician
    NPI EnumeratedMarch 31, 2006

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

    Payer SourceTotal Paid
    Medicare$102.8K
    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.

    22 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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…480$90$41.1K
    G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit100$120$11.7K
    99215The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…90$120$10.7K
    99497The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…90$70$6.2K
    93922Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral90$60$5.1K
    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…60$70$3.6K
    92548The provider performs computerized dynamic posturography sensory organization testing to evaluate the patient's motor, sensory, and integrative processes used to maintain balance and stability. The…90$40$3.1K
    93015The provider supervises the recording of the electrical activity of the heart to examine any abnormality in its functioning by obtaining blood pressure and electrocardiograph readings at regular…70$50$3.1K
    36415In this procedure, the provider inserts a needle into a vein to collect a blood sample.330$10$2.7K
    94375The provider performs a respiratory flow volume loop study to differentiate a patient's obstructive pulmonary disorder from restrictive pulmonary disorders. He may also use the procedure to…100$30$2.7K

    Showing 1–10 of 22

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    22 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992145144,690100$70$14.4K
    G04394601,15080$120$12.1K
    992133,1854,740100$50$8K
    992152031,22030$110$6.4K
    93015214080$50$3.7K
    G00088981,42060$30$3.7K
    994972310040$50$3.5K
    G044621040$20$3.4K
    94375410150$20$3.3K
    G043827037020$150$3.1K

    Showing 1–10 of 22

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Siouxland Community Health CenterIAFederally Qualified Health Center (FQHC)$0$87.6M
    Sioux City Community School DistrictIALocal Education Agency (LEA)$0$14M
    Family Access Center, Inc.IACommunity/Behavioral Health Agency$0$9.1M
    Prairie Pediatrics, PCIAPediatric Cardiology Physician$0$6.4M
    New Perspectives, Inc.IADevelopmentally Disabled Services Day Training Agency$0$5.4M
    Siouxland Regional Transit SystemIABus$0$2.4M
    Kham UngIAFoot & Ankle Surgery Podiatrist$56.3K$0
    Diane FitchIAMedical Physician Assistant$22.9K$0

    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. Iowa Distribution
    Mark Carlson — 1 of 22 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Iowa