Physician

Todd R Nelson, M.D.

According to 2025 Medicare claims, Todd Nelson, M.D. (NPI: 1457562126) practices family practice in the Racine-Mount Pleasant, WI market, with the plurality of this provider's patient population coming from Racine, WI. This provider's primary affiliated billing organization is AURORA MEDICAL GROUP, INC. (NPI: 1427271378; TIN: 391678306) and primary practice location at 53105-1828. Nelson is affiliated with the Advocate Physician Partners Accountable Care, Inc. (ACO ID: A1033) and Accountable Care Organization of Advocate Aurora Health, LLC (ACO ID: D0260), participating under both the MSSP and REACH models.

Nelson's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 390 traditional Medicare patients, billed 4,058 HCPCS/CPT codes, and received $112,134 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 9,772 prescription claims across 761 beneficiaries totaling $902,604 in drug costs, led by Jardiance (Empagliflozin). DME data shows 247 claims. No Open Payments records. 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 from a lower plateau to a higher plateau, from $39,573 to $112,134. Similarly, Part D prescription costs have moved sharply higher in recent years, from $196,103 to $902,604. In contrast, DME billing represents a smaller volume and rose steadily, from $2,338 to $11,216.

Part B Carrier Billing Trend

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

Year	Patients	Clm Lines	Payment
2015	262	940	$39,573
2016	177	1,385	$43,361
2017	211	973	$63,464
2018	487	8,151	$105,072
2019	500	8,928	$113,206
2020	441	7,260	$94,112
2021	442	6,559	$103,275
2022	453	5,227	$109,392
2023	420	3,937	$102,368
2024	390	4,058	$112,134

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	329	3,449	$196,103
2016	303	2,687	$166,281
2017	287	4,044	$274,948
2018	590	6,449	$428,215
2019	593	6,547	$462,358
2020	571	6,790	$502,114
2021	635	6,946	$543,182
2022	714	7,639	$668,562
2023	782	8,938	$865,204
2024	761	9,772	$902,604

DME Billing Trend

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

Year	Patients	Claims	Payment
2015	N/R	19	$400
2016	N/R	42	$1,678
2017	11	48	$818
2018	21	114	$2,199
2019	27	116	$2,097
2020	18	108	$2,069
2021	20	65	$801
2022	14	93	$1,693
2023	33	149	$4,981
2024	37	247	$6,055

* / # = 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	224	224	$121
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	223	399	$78
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	114	143	$46
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	169	275	$11
93793	Anticoagulant management of patient taking warfarin	105	1,320	$7

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Jardiance	Empagliflozin	119	7,143	$140,604
Ozempic	Semaglutide	90	3,542	$111,512
Eliquis	Apixaban	76	4,493	$86,813
Trelegy Ellipta	Fluticasone/Umeclidin/Vilanter	70	3,660	$78,728
Januvia	Sitagliptin Phosphate	31	2,490	$45,792

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	N/R	15	$1,303
A7031	Face mask interface, replacement for full face mask, each	N	N/R	16	$1,168
E0601	Continuous positive airway pressure (cpap) device	Y	N/R	31	$874
A4253	Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips	N	21	64	$796
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	Y	N/R	12	$728

Open Payments Summary

No connected Open Payments records were found for this physician in General Payments, Research Payments, or Ownership / Investment Interests.

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FAQ

What Medicare data is available for Todd R. Nelson, M.D.?

Tedicare shows public-source Medicare data for Todd R. Nelson, M.D. (NPI 1457562126), 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 Todd R. Nelson, M.D. have ACO affiliation data?

Todd R. Nelson, M.D. is shown with ACO affiliation data for Advocate Physician Partners Accountable Care, Inc. (MSSP, ACO ID A1033) and Accountable Care Organization of Advocate Aurora Health, LLC (REACH, ACO ID D0260).

What billing organization is linked to Todd R. Nelson, M.D.?

Todd R. Nelson, M.D. is linked to AURORA MEDICAL GROUP, INC. (billing NPI 1427271378) in the available physician profile data.

Does Todd R. Nelson, M.D. have Open Payments data?

No connected Open Payments records are shown for this physician in the available General Payments, Research Payments, or Ownership / Investment Interests 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.