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Dr. Nathaniel Harkins , O.D.

High Markup
Practice Location: Madison,Wisconsin 53715
National Provider Identifier (NPI): 1396032819
28 mins
Average Visit Time
6.12x
Markup Level
7,445
Annual Services
Financial Protection Alert

Higher Out-of-Pocket Billing Risk

This practice submits charges that average 6.1 times customary allowable rates. If you have not met your annual health insurance deductible, or if this doctor is out-of-network with your health plan, you may face significant balance billing.

3 Steps to Protect Your Wallet:
  • Confirm network status: Call your insurer to confirm this specific physician and office address are in-network.
  • Request in-network labs: Before blood draws or biopsies, ask the nurse to send samples exclusively to an in-network commercial laboratory.
  • Ask for a written estimate: Under the No Surprises Act, you are legally entitled to a Good Faith Estimate if you are self-pay or out-of-network.
The Rushed Visit Index

Thorough Listener

~28 min face-time

Consistently devotes longer face-to-face evaluations. Ideal for complex medical concerns, multiple symptoms, or patients who value comprehensive discussion without feeling rushed.

How is appointment length calculated?

Visit durations reflect official documentation standards for Evaluation and Management (E/M) office billing codes (CPT 99202 through 99215).

Physicians who bill higher-level comprehensive visits (such as 99214 and 99215) consistently spend 30 to 45 minutes reviewing complex records and discussing care plans, whereas routine refill clinics predominantly bill briefer level 2 and 3 codes.

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Appointment Length & Visit Style

Clinical appointment coding analysis across standard patient evaluations

Consultation Classification
Standard (20-30 mins)

Dr. Harkins provides standard-duration consultations averaging approximately 28 minutes per visit, aligned with typical medical practice guidelines.

What visit duration tells you:
•Thorough evaluations: Longer appointments mean more opportunity to ask questions, review medical histories, and explain treatment options.
•Complex medical care: Patients managing multiple chronic conditions or seeking second opinions often benefit from physicians with extended visit styles.
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Pricing Transparency & Fee Comparison

How this provider bills compared to standard insurance benchmarks

Pricing Markup Ratio
6.12x
National Specialty Average: 2.56x
Total Annual Charges Billed
$934,066
Gross billed amount on claims
Standard Benchmark Value
$152,536
Customary fee baseline
Practical Guide for Patients and Families:

⚠️ Price Outlier Warning: Dr. Harkins's submitted charges are significantly higher than peer medians (over 6.12x the baseline standard). If you receive treatment out-of-network or without insurance, you could face substantial bills. Confirm in-network participation with your health plan prior to booking.

Verified Clinical Procedures & Surgical Focus

Official annual procedure volumes, customary fee comparisons, and clinical focus areas.

Clinical Procedure & CodeAnnual ServicesDoctor ChargePeer NormStandard Baselinevs. Peer Norm
CPT 66984
4,767$79.21$1450.00$1.150.05x
CPT 66821
990$44.83$821.82$0.740.05x
CPT 92014
597$396.00$168.00$122.162.36x
CPT 92134
294$186.00$95.00$38.691.96x
CPT 99213
218$236.83$168.44$86.051.41x
CPT 92133
181$174.60$90.00$33.281.94x
CPT 92083
177$336.00$124.81$60.222.69x
CPT 99214
124$335.42$245.00$122.241.37x
👨‍⚕️ Physician & Medical Billing Intelligence (Click to view professional coding data)Expand ↓

This section provides clinical practice analytics for healthcare administrators, billing coders, and peer physicians evaluating practice benchmarks:

Evaluation & Management Mix

Estimated appointment time calculation: 28 minutes. Indicates the proportion of high-complexity (99205/99215) vs. moderate-complexity (99204/99214) documentation relative to national specialty peers.

Charge-to-Payment Ratio

Gross charge multiplier: 6.12x. Useful for fee schedule alignment, out-of-network charge master analysis, and payer contract negotiations.

Patient Guidance: What to Ask Before Your Appointment

  • In-Network Confirmation: Confirm directly with your insurance plan that Dr. Harkins participates in your specific network tier.
  • Surgical Facility Fees: If having surgery, verify whether it will be in a hospital or an outpatient surgery center. Facility charges are billed separately from physician fees.
  • Written Estimates: If you are paying out of pocket or have a high deductible, request a written good-faith estimate before major treatments.