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 Tolsma
    Ask Trek AI about this page

    Mark Tolsma — Billing Profile & Reimbursement Data

    NPI 1902588700 · Upper Saddle River, NJ · Family Nurse Practitioner

    Customize your policy alerts

    Sign up for Mark Tolsma — 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 Tolsma is a family nurse practitioner provider located in Upper Saddle River, New Jersey. This profile covers 11 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 Tolsma
    Address2 Park Way
    CityUpper Saddle River
    StateNJ
    ZIP07458
    TaxonomyFamily Nurse Practitioner
    NPI EnumeratedAugust 2, 2023

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

    Payer SourceTotal Paid
    Medicare$9.4K
    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.

    11 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99348The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30…50$60$2.7K
    99349The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…20$90$2K
    99344The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider spends at least…10$110$1.5K
    99342The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a low level of medical decision making or the provider spends at least 30…20$60$1.3K
    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…20$40$780
    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.30$20$420
    80047The lab analyst performs a basic metabolic panel (BMP) test in which he measures the blood level of eight chemicals identified in the descriptor including ionized calcium, sodium, potassium,…20$10$290
    36415In this procedure, the provider inserts a needle into a vein to collect a blood sample.20$10$190
    81002The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…20$1$70
    P9612Catheterization for collection of specimen, single patient, all places of service10$10$70

    Showing 1–10 of 11

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    11 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    99349513580100$90$20.7K
    364151,8502,200110$10$11.1K
    9934831551070$60$8.7K
    9934414618030$110$4.2K
    993428415030$60$2.7K
    8781123930030$40$2.1K
    85014182060$1$1.4K
    8780447062040$20$950
    80047365030$10$710
    810027781,39030$1$260

    Showing 1–10 of 11

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Friends Of Cyrus IiNJChild Intellectual and/or Developmental Disabilities Respite Care$0$118.8M
    Joseph KasperNJInternal Medicine Physician$523.7K$0
    Junno ParkNJPodiatrist$338.3K$520
    Michael MentakisNJInternal Medicine Physician$315.1K$0
    David SemarNJPsychiatry Physician$68.4K$0
    Leonard SilversteinNJSpecialist$65.1K$0
    John WinnNJChiropractor$54.6K$0
    Brittany BondNJOccupational Therapist$38.6K$0
    Renato MiguelNJAnesthesiology Physician$35.7K$0
    Monica MeyerNJGynecology Physician$33.1K$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. New Jersey Distribution
    Mark Tolsma — 0 of 11 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — New Jersey