Physician

Philomela Martirez Tabuena, MD

According to 2025 Medicare claims, Philomela Tabuena, MD (NPI: 1467659102) practices family practice in the Arlington-Alexandria-Reston, VA-WV market, with the plurality of this provider's patient population coming from Jefferson, WV. This provider's primary affiliated billing organization is EAST MOUNTAIN HEALTH PHYSICIANS INC. (NPI: 1598204273; TIN: 473767341) and primary practice location at 25438-1641. Tabuena is affiliated with the ACO West Virginia (ACO ID: A3563) and CoreHealth Alliance LLC (ACO ID: A5645), participating under the MSSP model.

Tabuena's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 295 traditional Medicare patients, billed 1,173 HCPCS/CPT codes, and received $76,733 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 8,157 prescription claims across 422 beneficiaries totaling $884,084 in drug costs, led by Ozempic (Semaglutide). DME data shows 149 claims. Open Payments data shows 47 records totaling $948. 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 risen steadily, from $57,458 to $76,733. Similarly, Part D prescription costs have moved sharply higher in recent years, from $277,308 to $884,084. In contrast, DME billing represents a smaller volume and 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	195	993	$57,458
2016	216	1,056	$60,286
2017	203	1,043	$52,603
2018	213	889	$46,725
2019	425	1,663	$70,997
2020	307	1,306	$62,540
2021	270	1,220	$72,885
2022	257	1,145	$66,695
2023	305	1,257	$92,706
2024	295	1,173	$76,733

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	227	4,072	$277,308
2016	265	4,631	$346,665
2017	254	5,246	$353,661
2018	273	5,274	$424,473
2019	472	6,929	$572,207
2020	457	7,145	$562,091
2021	372	7,118	$569,371
2022	430	7,703	$688,224
2023	427	7,904	$900,411
2024	422	8,157	$884,084

DME Billing Trend

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

Year	Patients	Claims	Payment
2015	14	270	$9,482
2016	12	240	$4,318
2017	13	117	$1,567
2018	13	101	$1,865
2019	14	149	$2,789
2020	20	227	$6,072
2021	50	308	$12,302
2022	N/R	163	$9,218
2023	N/R	145	$8,892
2024	22	149	$7,081

* / # = 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	69	69	$120
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	235	440	$72
90662	Influenza vaccine split virus, preservative free	40	40	$61
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	73	112	$53
G0008	Administration of influenza virus vaccine	42	42	$30

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Ozempic	Semaglutide	105	3,466	$113,244
Jardiance	Empagliflozin	71	5,250	$101,008
Trelegy Ellipta	Fluticasone/Umeclidin/Vilanter	94	4,110	$86,836
Farxiga	Dapagliflozin Propanediol	97	3,745	$64,541
Trulicity	Dulaglutide	30	1,402	$47,852

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	13	$2,825
E0601	Continuous positive airway pressure (cpap) device	Y	N/R	23	$1,243
A7030	Full face mask used with positive airway pressure device, each	N	N/R	11	$894
A7031	Face mask interface, replacement for full face mask, each	N	N/R	20	$780
A4604	Tubing with integrated heating element for use with positive airway pressure device	N	N/R	12	$557

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	47	$948	AstraZeneca Pharmaceuticals LP
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 Philomela Martirez Tabuena, MD?

Tedicare shows public-source Medicare data for Philomela Martirez Tabuena, MD (NPI 1467659102), 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 Philomela Martirez Tabuena, MD have ACO affiliation data?

Philomela Martirez Tabuena, MD is shown with ACO affiliation data for ACO West Virginia (MSSP, ACO ID A3563) and CoreHealth Alliance LLC (MSSP, ACO ID A5645).

What billing organization is linked to Philomela Martirez Tabuena, MD?

Philomela Martirez Tabuena, MD is linked to EAST MOUNTAIN HEALTH PHYSICIANS INC. (billing NPI 1598204273) in the available physician profile data.

Does Philomela Martirez Tabuena, MD have Open Payments data?

Philomela Martirez Tabuena, MD has 47 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.