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    v1.0.28
    OpenPayerNPI Medicare & MedicaidRafael Medina-flores
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    Rafael Medina-flores — Billing Profile & Reimbursement Data

    NPI 1891898235 · Marshfield, WI · Anatomic Pathology & Clinical Pathology Physician

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    Rafael Medina-flores is a anatomic pathology & clinical pathology physician provider located in Marshfield, Wisconsin. This profile covers 39 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
    OrganizationRafael Medina-flores
    Address1000 N Oak Ave
    CityMarshfield
    StateWI
    ZIP54449
    TaxonomyAnatomic Pathology & Clinical Pathology Physician
    NPI EnumeratedSeptember 7, 2006

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

    Payer SourceTotal Paid
    Medicare$116K
    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.

    39 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    36415In this procedure, the provider inserts a needle into a vein to collect a blood sample.3,220$10$25.8K
    85025A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…1,490$10$11.9K
    80053The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.1,180$10$11.8K
    80061The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.830$10$10.7K
    0241UN/A60$140$7.8K
    84443The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…490$20$7.8K
    80048The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…720$10$5.7K
    83036Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…560$10$5.6K
    88305The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…240$20$5.5K
    36591The provider collects a blood specimen from a completely implantable venous access device that he placed in a prior procedure.140$20$2.8K

    Showing 1–10 of 39

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 39 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    39 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    88305228300460$40$44.8K
    83880144030$40$16.8K
    0241U56020$140$7.5K
    88341226240190$30$7.4K
    8834221127090$40$6.9K
    800531245040$10$6.3K
    844431233030$20$6.2K
    800611353040$10$5.1K
    8830718721060$60$5K
    84100133070$1$3.4K

    Showing 1–10 of 39

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Rafael Medina-flores, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Black River Health IncWICritical Access Hospital$0$13M
    Lakeview Medical Center Inc Of Rice LakeWIRural Acute Care Hospital$0$10M
    Flambeau Hospital IncWICritical Access Hospital$0$7M
    Lakeview Medical Center Inc Of Rice LakeWIRural Health Clinic/Center$0$2.2M
    Lee HoferWIOphthalmology Physician$1.7M$0
    Lakeview Medical Center Inc Of Rice LakeWIClinic/Center$0$1.6M
    Maxim PolanskyILMOHS-Micrographic Surgery Physician$984.1K$0
    Topeka Physician Group, LLCKSInternal Medicine Physician$0$963.7K
    Darrin JohnsonMNDiagnostic Radiology Physician$908.4K$0
    Ammar TahaWIDiagnostic Radiology Physician$410.5K$380K

    Nearby Providers

    Other providers in the same ZIP code as Rafael Medina-flores, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Mchs Hospitals IncWIRural Acute Care Hospital$0$45.3M
    Family Health Center Of Marshfield IncWIDental Clinic/Center$0$20.4M
    Marshfield Clinic IncWIClinic/Center$526.8K$19.6M
    Mchs Hospitals IncWIClinic/Center$0$11.8M
    Family Health Center Of Marshfield IncWIFederally Qualified Health Center (FQHC)$0$3.4M
    Family Health Center Of Marshfield IncWIFederally Qualified Health Center (FQHC)$0$3.2M
    Marriage & Family Health Services, Ltd.WIAdolescent and Children Mental Health Clinic/Center$0$2.6M
    Mchs Hospitals IncWILand Ambulance$1.4M$987.9K
    School District Of MarshfieldWILocal Education Agency (LEA)$0$1.7M
    Total Renal Care IncWIEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center$0$1.3M

    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. Wisconsin Distribution
    Rafael Medina-flores — 9 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Wisconsin