Dr. John Whalen, MD
1500 Delhi St Ste 2100, Dubuque, IA 52001 • +1-555-555-9195
Medical Education: Accredited U.S. Medical School (Class of 2000)
What This Doctor Actually Performs: CMS Medicare Utilization & Dubuque Percentiles
NPI #1285694802 • CBSA Regional • Nephrology
Dr. John Whalen, MD (NPI #1285694802) practices Nephrology in Dubuque, IA (52001) with sub-specialty concentration in 97 Active CMS HCPCS Codes, recording 22,631 annual CMS services across 568 distinct beneficiaries—placing this practice as a focused low-volume boutique caseload (33.33th Dubuque percentile) (+1.67σ vs IA state mean, 92.68th statewide percentile).
Fee-schedule auditing of NPI 1285694802 highlights 2116 annual claims for 99214 (33.33th Dubuque percentile; $45–$62 self-pay corridor) plus 970 encounters under 90960 and 793 under 99215.
Direct cash-pay transparency modeling sets Dr. Whalen's baseline new-consult rate near $209.00 in Dubuque, IA (cash-pay accepted, hybrid in-clinic and telehealth video consults, 22-minute average reception wait).
Spanning 26 years of clinical practice following 2000 graduation from medical training, Dr. John Whalen integrates 97 Active CMS HCPCS Codes diagnostics for Dubuque metro patients.
Compared against Dubuque, IA Nephrology peers
22,631 annual services across 568 beneficiaries
Standard deviations from IA Nephrology mean utilization
Top Billed HCPCS/CPT Procedures & GPCI Self-Pay Cash Benchmarks
| HCPCS | Clinical Procedure Description | Annual Volume | Local Pct | Est. Cash Range |
|---|---|---|---|---|
| 99214 | Chronic Kidney Disease eGFR, uACR & Electrolyte Management | 2,116 | 33.33th | $45 – $62 |
| 90960 | Monthly Adult ESRD Renal Replacement Oversight | 970 | 32.33th | $91 – $124 |
| 99215 | High-Complexity Cardiorenal & Resistant Hypertension Visit | 793 | 29.33th | $66 – $91 |
| 99204 | New Patient Nephrology & Proteinuria Consultation | 529 | 34.33th | $62 – $85 |
| 96372 | Therapeutic Subcutaneous/Intramuscular Injection Administration (97 HCPCS billing breadth) | 18,223 | 33.33th | $45 – $65 |
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Dr. John Whalen, MD Fair Cash-Pay & Waiting-Room Scorecard
| Metric | Verified Benchmark | Source |
|---|---|---|
| Dr. Whalen National Provider Identifier | NPI #1285694802 (MD) | CMS NPPES Registry (52001) |
| Dr. Whalen Dubuque CMS Volume Rank | 33.33th Pct (22,631 CMS svcs; Z +1.669σ) | CMS Medicare Part B (IA Nephrology) |
| Fair Cash-Pay New-Patient Benchmark | $209.00 (CPT 99204 GPCI Benchmark) | CMS Geographic Practice Cost Index (Dubuque, IA) |
| Waiting-Room Wait Time & Cash Friendliness | $209.00 avg paid • 22 min lobby wait | 20 Anonymous Patient Reports |
| Listens Without Rushing & Modern Protocol Score | 4.60/5 Listening • 4.66/5 Modern Labs | CMS Provider Practice Cohort |
“Waiting Room” Patient Reality Scorecard
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