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    OpenPayerNPI Medicare & MedicaidJason Fogg
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    Jason Fogg — Billing Profile & Reimbursement Data

    NPI 1831338151 · Henderson, KY · Pain Medicine (Physical Medicine & Rehabilitation) Physician

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    Jason Fogg is a pain medicine (physical medicine & rehabilitation) physician provider located in Henderson, Kentucky. This profile covers 18 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
    OrganizationJason Fogg
    Address1305 N Elm St
    CityHenderson
    StateKY
    ZIP42420
    TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
    NPI EnumeratedFebruary 10, 2009

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

    Payer SourceTotal Paid
    Medicare$1.2M
    Medicaid$0

    Key Findings

    Specialty and service mix: As a Pain Medicine (Physical Medicine & Rehabilitation) physician, this provider’s Medicare billing is heavily procedural — dominated by intra‑articular viscosupplementation and image‑guided injection services. The largest single code is J7320 (85.3K claims, $426.5K revenue, 40.0% of provider’s Medicare revenue), and the profile also includes high volumes for 77002 and 20610, consistent with an interventional pain clinic focused on fluoroscopically guided and joint injection procedures rather than primary E&M care.

    Revenue concentration: Medicare receipts total $1.2M and are highly concentrated: the precomputed top 3 codes account for 83.0% of this provider’s total Medicare revenue. Those top three contributors are J7320 (40.0%), 77002 (26.1%), and 20610 (16.9%), indicating most Medicare dollars flow from a very narrow set of procedures.

    Payer mix / single‑payer exposure: This provider reports Total Medicare revenue of $1.2M and has no Medicaid billing on file, i.e., none below. The practice is effectively single‑payer (Medicare) in the available data, which concentrates reimbursement exposure to Medicare fee schedules and contract changes.

    National competitive standing: For several high‑revenue procedural codes this provider ranks at the very top nationally — J7320 ranks #9 of 462 providers (98th percentile; extreme outlier), 77002 ranks #9 of 7010 providers (100th percentile; extreme outlier), and 20610 ranks #16 of 39752 providers (100th percentile; extreme outlier). These rank/percentile positions indicate the provider is a major national outlier in volume for these specific procedures relative to peers.

    Contrast material and supply coding pattern: The provider shows very high claim counts for contrast HCPCS with asymmetric reimbursement: Q9965 appears as 93.2K claims and $93.2K revenue (8.7% of Medicare revenue) and ranks #5 of 299 (99th percentile; extreme outlier), while Q9966 shows 110.7K claims but $0 revenue and ranks #4 of 1716 (100th percentile; extreme outlier). This pattern suggests unusually large per‑claim contrast utilization by count, with low or zero paid amounts recorded for at least one contrast code, a coding/reimbursement nuance worth reviewing.

    E&M activity is present but low relative to procedures: Office visit codes appear in the top 25 but generate modest revenue — for example, 99212 (270 claims, $9.7K, 0.9% of Medicare revenue) and 99202 (149 claims, $7K, 0.7% of Medicare revenue). Both E&M codes rank notably above typical national volume (99212 at the 96th percentile and 99202 at the 98th percentile) but remain small contributors to total revenue, reinforcing a procedure‑centric practice model.

    Tenure and billing history: The provider’s NPI was enumerated 2009-02-10 (~17 years ago), indicating a long‑standing presence in the Medicare dataset. This tenure supports interpretation of the observed high procedural volumes as established practice patterns rather than a short‑term spike.

    Operational implication and concentration risk: Given that the top three Medicare codes drive 83.0% of Medicare revenue and the practice records several national 'extreme outlier' ranks for image‑guided injections and viscosupplementation, the business is concentrated in a few high‑volume procedures. That concentration implies sensitivity to reimbursement policy changes, coverage determinations for hyaluronan and fluoroscopy guidance, and payer audit focus on high‑ranked procedure codes.

    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.

    18 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J7320Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg85,300$10$426.5K
    77002The provider uses fluoroscopic guidance to place a needle for biopsy, aspiration, injection, or localization of a device to detect any lesions in any area of the body, except for the spine, or to…3,300$80$277.5K
    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…3,330$50$179.7K
    Q9965Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml93,190$1$93.2K
    J3304Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg2,880$10$37.4K
    J7323Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose160$90$15.2K
    99212The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…270$40$9.7K
    J7325Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg1,060$10$7.4K
    99202The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…150$50$7K
    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…20$130$3K

    Showing 1–10 of 18

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    18 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J73202106,550$10$168.1K
    J33047301,570$10$29.3K
    Q9965210130$1$27K
    J732523301,630$10$15.3K
    992145,4607,230110$70$14.1K
    994261010180$50$11.3K
    77002212040$70$10.1K
    J732321060$100$9.6K
    20610264080$40$6.6K
    992041,9733,20030$100$4.8K

    Showing 1–10 of 18

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Appalachian Regional Healthcare, Inc.KYGeneral Acute Care Hospital$0$107.9M
    Appalachian Regional Healthcare, Inc.KYGeneral Acute Care Hospital$0$55.1M
    Methodist Health, Inc.KYGeneral Acute Care Hospital$0$51M
    Columbus Radiology CorpOHDiagnostic Radiology Physician$0$49.9M
    Appalachian Regional Healthcare, Inc.KYGeneral Acute Care Hospital$0$38.9M
    Arh Tug Valley Health Services, Inc.KYGeneral Acute Care Hospital$0$33.8M
    Appalachian Regional Healthcare, Inc.KYGeneral Acute Care Hospital$0$33.4M
    Union Associated Physicians Clinic, LLCINFamily Medicine Physician$0$31.1M
    Appalachian Regional Healthcare, Inc.KYCritical Access Hospital$0$26.9M
    Appalachian Regional Healthcare, Inc.KYGeneral Acute Care Hospital$0$26.8M

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Lighthouse Counseling Services, Inc.KYMental Health Counselor$0$12.1M
    Stability Counseling And Associates LLCKYMental Health Counselor$0$6.5M
    Robert WagonerKYOral & Maxillofacial Surgery (D.M.D.)$0$4.7M
    Brad T Fulkerson, Dmd,msd,llcKYPediatric Dentistry$0$3.6M
    Community Alternatives Kentucky, Inc.KYDevelopmentally Disabled Services Day Training Agency$0$3.3M
    Hugh E Sandefur Ind IncKYContractor$0$3.1M
    James FellowsKYUrology Physician$192.2K$137.8K
    Anthony PerkinsKYDiagnostic Radiology Physician$259K$0
    Michael RoofKYFamily Medicine Physician$226.9K$0
    Sridhar BanuruKYCardiovascular Disease Physician$214.7K$1.9K

    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. Kentucky Distribution
    Jason Fogg — 4 of 16 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Kentucky