Physician

Marc L Benton, M.D.

According to 2025 Medicare claims, Marc Benton, M.D. (NPI: 1003817156) practices sleep medicine in the Newark, NJ market, with the plurality of this provider's patient population coming from Morris, NJ. This provider's primary affiliated billing organization is SD DIAGNOSTICS INC (NPI: 1487192779; TIN: 462155766) and primary practice location at 10605-2217. Benton is affiliated with the Summit Health ACO (ACO ID: A5049) and Aledade 196 Advocare Collaborative Health MSSP (ACO ID: A5364), participating under the MSSP model.

Benton's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 130 traditional Medicare patients, billed 167 HCPCS/CPT codes, and received $14,613 in Medicare payments. The top billing code was 99203 (New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more). Part D data shows 93 prescription claims across 38 beneficiaries totaling $60,541 in drug costs, led by Trelegy Ellipta (Fluticasone/Umeclidin/Vilanter). DME data shows 3,194 claims. Open Payments data shows 3 records totaling $154. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has declined steadily, from $269,261 to $14,613. Similarly, Part D prescription costs have declined steadily, from $720,241 to $60,541. For DME billing, reported payments did not follow a clear longitudinal pattern.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	730	6,180	$269,261
2016	746	3,036	$224,990
2017	798	2,763	$301,229
2018	788	2,440	$280,902
2019	721	2,090	$227,638
2020	712	1,549	$151,971
2021	714	1,743	$198,502
2022	794	1,644	$188,179
2023	512	688	$67,036
2024	130	167	$14,613

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	265	1,913	$720,241
2016	251	1,741	$704,438
2017	241	1,680	$678,386
2018	239	1,463	$635,105
2019	218	1,264	$527,587
2020	219	1,192	$563,771
2021	181	942	$492,015
2022	176	920	$453,269
2023	153	702	$374,069
2024	38	93	$60,541

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	3,286	7,913	$387,202
2016	3,658	9,131	$374,688
2017	3,555	8,324	$312,675
2018	3,702	8,365	$329,525
2019	3,325	7,616	$270,600
2020	3,345	7,738	$277,615
2021	3,460	7,268	$266,407
2022	3,723	8,547	$327,926
2023	3,071	6,835	$260,776
2024	1,744	3,194	$121,322

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
99203	New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	36	36	$95
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	97	112	$82

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Trelegy Ellipta	Fluticasone/Umeclidin/Vilanter	25	1,590	$32,650
Breo Ellipta	Fluticasone/Vilanterol	13	1,110	$13,576
Budesonide-Formoterol Fumarate	Budesonide/Formoterol Fumarate	11	330	$1,352
Montelukast Sodium	Montelukast Sodium	14	1,200	$199

Top 5 DME services in 2024

By Total Medicare Payment Amount.

HCPCS Code	HCPCS Description	Supplier Rental Indicator	Total Supplier Beneficiaries	Total Supplier Claims	Total Medicare Payment Amount
A7030	Full face mask used with positive airway pressure device, each	N	143	262	$19,212
A7031	Face mask interface, replacement for full face mask, each	N	124	243	$17,484
A4604	Tubing with integrated heating element for use with positive airway pressure device	N	242	467	$15,428
A7034	Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap	N	170	329	$14,790
A7032	Cushion for use on nasal mask interface, replacement only, each	N	76	152	$13,032

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	3	$154	Inspire Medical Systems, Inc.
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

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FAQ

What Medicare data is available for Marc L. Benton, M.D.?

Tedicare shows public-source Medicare data for Marc L. Benton, M.D. (NPI 1003817156), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Marc L. Benton, M.D. have ACO affiliation data?

Marc L. Benton, M.D. is shown with ACO affiliation data for Summit Health ACO (MSSP, ACO ID A5049) and Aledade 196 Advocare Collaborative Health MSSP (MSSP, ACO ID A5364).

What billing organization is linked to Marc L. Benton, M.D.?

Marc L. Benton, M.D. is linked to SD DIAGNOSTICS INC (billing NPI 1487192779) in the available physician profile data.

Does Marc L. Benton, M.D. have Open Payments data?

Marc L. Benton, M.D. has 3 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.