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    OpenPayerNPI Medicare & MedicaidDarlene Males
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    Darlene Males — Billing Profile & Reimbursement Data

    NPI 1821599101 · Wakefield, RI · Family Nurse Practitioner

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    Darlene Males is a family nurse practitioner provider located in Wakefield, Rhode Island. This profile covers 13 Medicare and 4 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)

    FieldValue
    Entity TypeIndividual
    OrganizationDarlene Males
    Address481 Kingstown Rd
    CityWakefield
    StateRI
    ZIP02879
    TaxonomyFamily Nurse Practitioner
    NPI EnumeratedFebruary 22, 2018

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

    Payer SourceTotal Paid
    Medicaid$137.7K
    Medicare$17.3K

    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…170$50$8.7K
    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…40$70$2.8K
    87811The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…50$40$1.8K
    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…20$60$1.1K
    87804The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.50$20$830
    71046In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…40$20$670
    96372A 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…60$10$620
    70210The provider performs X–ray examination of paranasal sinuses for the assessment of sinusitis.20$20$290
    G0444Annual depression screening, 5 to 15 minutes10$20$180
    93000The 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…20$10$140

    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
    992141,4331,950100$80$11.7K
    992134251,95070$60$7.4K
    9920344658030$70$3.6K
    71046117150130$10$2.8K
    8781172030$40$2.4K
    G0444738050$20$1.3K
    87804164040$20$940
    9300029138030$10$810
    96372186050$10$670
    7021051020$20$650

    Showing 1–10 of 13

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    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

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    4 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…1,700$50$83.4K
    80307The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.1,460$40$54K
    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…20$40$610
    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…10$50$590

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Rhode Island median

    4 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    80307The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.1350330$50$2.7M
    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…1,5421,730220$70$75.2K
    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…3422,050300$50$72.3K
    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…30235080$90$40.5K

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Vmd Primary Providers Of Rhode Island PCRIFamily Medicine Physician$0$780.7K
    Pamela BagdasianRIPhysician Assistant$32.5K$617.3K
    Jan UrkevicMAPsychiatry Physician$277.5K$344.8K
    Julius TabeMAFamily Medicine Physician$449.6K$2.5K
    Mussa MohamedMASurgery Physician$428K$0
    Nelson AwehMAInternal Medicine Physician$425.3K$0
    David WestrinMAAdult Health Nurse Practitioner$424.2K$0
    Kristen HavilandRIFamily Nurse Practitioner$7.4K$410.7K
    Ocean State Urgent Care Center Of Smithfield LLCRIUrgent Care Clinic/Center$0$403.1K
    Ramon EspinosaMAInternal Medicine Physician$368.2K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    South County Hospital Healthcare SystemRIGeneral Acute Care Hospital$0$5.3M
    Eric ProssedaRIGeneral Practice Dentistry$0$5.2M
    Joey NapolitanoRIPublic Health Dentistry$0$1.7M
    Elise JarvisRIMental Health Counselor$0$1.7M
    Rhode Island Pet Services, LLCRIMobile Radiology Clinic/Center$773.2K$497.1K
    Catherine DegoodRIAddiction Medicine (Family Medicine) Physician$3.1K$1.1M
    Emergency Physician Associates Of New England PCRIEmergency Medicine Physician$0$1M
    Ira KulmanRIClinical Neuropsychologist$0$1M
    South Kingstown School DepartmentRILocal Education Agency (LEA)$0$814K
    Emily ColyerRIEmergency Medicine Physician$36K$528.6K

    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. Rhode Island Distribution
    Darlene Males — 0 of 11 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Rhode Island
    Medicaid Revenue by Year vs. Rhode Island Providers
    0 of 4 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Rhode Island Distribution
    Darlene Males — 0 of 4 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Rhode Island