Brian Creghan — Billing Profile & Reimbursement Data
NPI 1023138708 · Hawthorne, FL · Medical Physician Assistant
Customize your policy alerts
Sign up for Brian Creghan — Billing Profile & Reimbursement Data policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Brian Creghan is a medical physician assistant provider located in Hawthorne, Florida. This profile covers 9 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Brian Creghan |
| Address | 21815 Se 71st Ave |
| City | Hawthorne |
| State | FL |
| ZIP | 32640 |
| Taxonomy | Medical Physician Assistant |
| NPI Enumerated | March 29, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $69.9K |
| Medicaid | $0 |
Key Findings
The provider’s billing mix is heavily weighted toward home- and residence-based evaluation & management (E/M) visits alongside routine office visits and a small volume of procedure codes. High-revenue codes include 99349, 99350, 99344, and 99348 (home/residence E/M) as well as 99213 and 99214 (office/outpatient E/M), and the presence of 11042 indicates some wound debridement procedures bundled into the practice offering.
Revenue concentration is high: the top three Medicare codes account for 78.3% of this provider’s total Medicare revenue, and 99349 alone contributes $40.2K of the $69.9K in Medicare revenue. This level of concentration indicates that a single service type—established-patient home visits—is the primary revenue driver for the practice.
Payer mix is effectively single-payer: Medicare is the only payer on file with $69.9K in lifetime revenue while there is no Medicaid billing on file. The absence of Medicaid activity means the provider’s public-payer exposure is concentrated entirely in Medicare, which has implications for contracting and outreach strategies focused on older adults and home-based care.
Despite the dominance of home visit revenue, the provider’s volume for primary codes is described as statistically typical rather than exceptional. For example, 99349 (57.4% of Medicare revenue) is labeled as "typical, unremarkable volume for this code," and 99213 (12.3% of Medicare revenue) is also labeled "typical, unremarkable volume for this code," indicating the provider is not flagged as an extreme outlier in national comparisons.
Several high-intensity visit codes appear in the top code set, suggesting time-intensive encounters are a feature of the practice. Codes such as 99350 (44 claims, $5.6K revenue) and 99344 (42 claims, $3.7K revenue) represent longer-duration or higher-decision-making home visits, which aligns with a care model that prioritizes extended in-home assessment or complex case management.
The presence of procedure code 11042 (44 claims, $4K revenue) alongside E/M codes points to a mixed service line that includes wound care or debridement in addition to visit-based E/M. This combination implies the provider may offer hands-on wound treatment during home or office encounters, adding a procedural revenue stream to the E/M-dominated profile.
On scale and competitive standing, the provider’s lifetime Medicare revenue of $69.9K is modest and the rank descriptors across top codes characterize this profile as a modest participant nationally rather than a dominant player. High-share code 99349 ranks in the national percentile band described as "typical, unremarkable volume for this code," reinforcing that the provider occupies a middle-tier position for its core services.
The provider has an established NPI tenure (enumerated 2007-03-29, ~19 years ago), which suggests long-term operation and likely sustained relationships with a Medicare patient base. This longevity combined with a concentrated, home-visit-focused service mix may support predictable, ongoing revenue from repeat home-based E/M encounters.
Medicare: Total Revenue Breakdown by CPT/HCPCS Code
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
Medicare: Complete Services Breakdown
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99349 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least… | 490 | $80 | $40.2K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 150 | $60 | $8.6K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 80 | $80 | $6K |
| 99350 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60… | 40 | $130 | $5.6K |
| 11042 | The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2. | 40 | $90 | $4K |
| 99344 | The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider spends at least… | 40 | $90 | $3.7K |
| 99348 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30… | 20 | $50 | $980 |
| G0008 | Administration of influenza virus vaccine | 20 | $30 | $490 |
| 90688 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It uses split virus technology and is given as a 0.5 mL dose. | 20 | $20 | $320 |
Medicare: Competitive Analysis & Benchmarks
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
Frequently Asked Questions
References
- 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
- 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.