Physician

Mark Himes, DO

According to 2025 Medicare claims, Mark Himes, DO (NPI: 1043571458) practices family practice in the Farmington, NM market, with the plurality of this provider's patient population coming from San Juan, NM. This provider's primary affiliated billing organization is SAN JUAN MEDICAL GROUP PC (NPI: 1609809235; TIN: 85-0438294) and primary practice location at 87401-6589. Himes is affiliated with the Aledade 57 Western Sky MSSP Enhanced (ACO ID: A4756), participating under the MSSP model.

Himes' data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 723 traditional Medicare patients, billed 9,204 HCPCS/CPT codes, and received $345,989 in Medicare payments. The top billing code was G0439 (Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit). Part D data shows 5,348 prescription claims across 338 beneficiaries totaling $544,904 in drug costs, led by Ozempic (Semaglutide). DME data shows 461 claims. Open Payments data shows 31 records totaling $587. 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 moved sharply higher in recent years, from $11,474 to $345,989. Similarly, Part D prescription costs have moved sharply higher in recent years, from $42,734 to $544,904. In contrast, DME billing represents a smaller volume and moved sharply higher in recent years, from $1,626 to $60,628.

Part B Carrier Billing Trend

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

Year	Patients	Clm Lines	Payment
2015	N/R	N/R	N/R
2016	73	458	$11,474
2017	216	1,852	$46,842
2018	245	3,523	$63,384
2019	257	3,448	$63,325
2020	281	3,650	$67,088
2021	375	5,063	$127,651
2022	640	6,410	$202,296
2023	711	7,660	$263,144
2024	723	9,204	$345,989

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	119	951	$42,734
2016	88	239	$11,604
2017	131	1,160	$79,806
2018	157	2,179	$154,045
2019	186	2,567	$192,098
2020	207	3,062	$248,982
2021	272	3,730	$351,907
2022	307	4,519	$449,228
2023	324	5,138	$507,675
2024	338	5,348	$544,904

DME Billing Trend

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

Year	Patients	Claims	Payment
2015	N/R	N/R	N/R
2016	N/R	N/R	N/R
2017	N/R	25	$704
2018	15	126	$3,279
2019	11	79	$2,191
2020	15	122	$3,355
2021	29	222	$16,479
2022	77	442	$19,587
2023	118	616	$34,535
2024	104	461	$31,609

* / # = 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
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	445	445	$122
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	594	1,281	$77
80053	Blood test, comprehensive group of blood chemicals	450	604	$10
36415	Insertion of needle into vein for collection of blood sample	471	692	$9
85025	Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	429	517	$8

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Ozempic	Semaglutide	80	3,450	$106,245
Jardiance	Empagliflozin	78	4,990	$91,673
Mounjaro	Tirzepatide	31	1,222	$41,997
Trulicity	Dulaglutide	27	1,008	$31,892
Xarelto	Rivaroxaban	27	1,410	$24,474

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
A4239	Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service	N	N/R	36	$17,706
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	Y	15	93	$6,603
A7031	Face mask interface, replacement for full face mask, each	N	N/R	17	$1,236
E0470	Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)	Y	N/R	13	$1,112
A7030	Full face mask used with positive airway pressure device, each	N	N/R	13	$975

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	31	$587	Astellas Pharma US 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 Mark Himes, DO?

Tedicare shows public-source Medicare data for Mark Himes, DO (NPI 1043571458), 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 Mark Himes, DO have ACO affiliation data?

Mark Himes, DO is shown with ACO affiliation data for Aledade 57 Western Sky MSSP Enhanced (MSSP, ACO ID A4756).

What billing organization is linked to Mark Himes, DO?

Mark Himes, DO is linked to SAN JUAN MEDICAL GROUP PC (billing NPI 1609809235) in the available physician profile data.

Does Mark Himes, DO have Open Payments data?

Mark Himes, DO has 31 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.