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    v1.0.28
    OpenPayerNPI Medicare & MedicaidEdward Nelson
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    Edward Nelson — Billing Profile & Reimbursement Data

    NPI 1720085459 · Cincinnati, OH · Pain Medicine Physician

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    Edward Nelson is a pain medicine physician provider located in Cincinnati, Ohio. This profile covers 13 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
    OrganizationEdward Nelson
    Address7691 5 Mile Rd Ste 10
    CityCincinnati
    StateOH
    ZIP45230
    TaxonomyPain Medicine Physician
    NPI EnumeratedJuly 7, 2005

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

    Payer SourceTotal Paid
    Medicare$165.3K
    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.

    13 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…840$60$52.3K
    G0481Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…280$150$42.2K
    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…460$90$40.5K
    80307The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.370$60$22K
    90832In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…70$60$4K
    99205The provider sees a new 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 provider…10$170$2K
    96365The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.40$40$1.9K
    J1030Injection, methylprednisolone acetate, 40 mg30$10$190
    J3010Injection, fentanyl citrate, 0.1 mg140$1$140
    J7040Infusion, normal saline solution, sterile (500 ml = 1 unit)40$1$40

    Showing 1–10 of 13

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    13 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    G04811030120$150$30.5K
    8030717100150$60$18.8K
    992141,40520,010100$70$11.7K
    9921317420,00070$50$6.6K
    908328521060$50$6.5K
    9636513524060$40$4.6K
    992051,8412,13020$140$4.2K
    Q99671581801,990$1$660
    J103019230040$10$480
    J3010510140$1$160

    Showing 1–10 of 13

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Suresh Gupta Md IncOHSpecialist$0$8.4M
    Paul PinsonTNPain Medicine (Anesthesiology) Physician$178.7K$1.7M
    Wynndel BuengerILPain Medicine Physician$399.4K$4.5K
    Albert SinghILPain Medicine (Physical Medicine & Rehabilitation) Physician$276.6K$29.3K
    Michael DankoOHPain Medicine (Anesthesiology) Physician$273.5K$0
    Joey ThomasNCPain Medicine (Anesthesiology) Physician$251.6K$0
    Bhimavarapu ReddyOHPain Medicine (Anesthesiology) Physician$233.1K$0
    Jeffrey HallTNPain Medicine (Anesthesiology) Physician$216.5K$0
    Srinivas ErragollaOHPain Medicine (Physical Medicine & Rehabilitation) Physician$196.3K$0
    Priyesh MehtaOHPain Medicine (Physical Medicine & Rehabilitation) Physician$162.7K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Cg Medical Associates IncOHUrgent Care Clinic/Center$0$42.1M
    Joel SorgerOHOrthopaedic Surgery Physician$193.5K$0
    Louis SchottOHOphthalmology Physician$177.2K$0
    Tiffany PickupOHDermatology Physician$164.6K$0
    Mahbod ArefiOHPodiatrist$114.8K$0
    Meghan JezOHMedical Physician Assistant$105.1K$0
    Kevin ShumrickOHOtolaryngology/Facial Plastic Surgery Physician$99.8K$0
    James LytleOHSurgical Physician Assistant$84.1K$0
    Monica NguOHInternal Medicine Physician$68.1K$0
    Joseph HellmannOHOtolaryngology Physician$62.4K$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. Ohio Distribution
    Edward Nelson — 1 of 10 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Ohio