Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Delaware for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Delaware only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Delaware (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Kathryn O'reilly (NPI 1033370408)

Field	Value
Entity Type	Individual
Organization	Kathryn O'reilly
Address	750 Kings Hwy
City	Lewes
State	DE
ZIP	19958
Taxonomy	MOHS-Micrographic Surgery Physician
NPI Enumerated	June 18, 2008

Payer Source	Total Paid
Medicare	$1.3M
Medicaid	$0

Key Findings

This provider is effectively a Medicare single‑payer practice: Total Medicare revenue is $1.3M and there is no Medicaid billing on file. The absence of Medicaid activity indicates the provider’s commercial/payer mix is concentrated in Medicare payments rather than dual‑payer volume.

Revenue concentration is high: the precomputed top‑3 Medicare codes account for 39.0% of the provider’s total Medicare revenue, with 99213 contributing $196.6K (15.6%), 77280 contributing $173.9K (13.8%), and G6001 contributing $121.5K (9.6%). This indicates a reliance on a small set of high‑yield codes for a large share of overall Medicare receipts.

The code mix points to a hybrid dermatologic surgical and radiation‑planning practice. High‑revenue dermatologic procedure codes appear (e.g., 17311 at $99.5K and 11102 at $83.5K) alongside radiation‑simulation and guidance codes (77280 at $173.9K and G6001 at $121.5K), suggesting the provider bills both Mohs/skin‑procedure services and radiation therapy planning/guidance services.

Several common dermatology procedure codes are extreme outliers in national volume, implying unusually high procedural throughput relative to peers: 99213 (2.9K claims, $196.6K revenue) ranks as an "extreme outlier" nationally (100th percentile), and procedural codes 17110 ($94.7K revenue), 11102 ($83.5K revenue), 17000 ($67.7K revenue), 17003 ($34.2K revenue) and 99203 ($28.5K revenue) are also flagged as extreme outliers in their national rankings. These labels reflect substantially higher billed volumes for routine dermatology encounters and lesion management compared with national peers.

Not all high‑volume codes are outliers: radiation guidance code G6001 (821 claims, $121.5K revenue) ranks in the 63th percentile and is described as "typical, unremarkable volume," while 77280 (787 claims, $173.9K revenue) ranks in the 96th percentile and is "notably above typical national volume." This suggests that simulation services (77280) are a relatively prominent revenue source compared with national peers, while some radiation guidance services are in line with typical practice volumes.

The provider’s competitive standing is mixed by code: for several E/M and minor procedure codes the provider ranks at or near national top percentiles (e.g., 99213 at 100th percentile; 11102 at 100th percentile; 17110 at 100th percentile), indicating dominant national volume for those services, whereas more specialized radiation and physics codes (e.g., G6001, 77336) fall in more middle percentiles, indicating modest participation relative to the narrower specialty peer sets.

Clinical tenure is long enough to suggest an established practice footprint: NPI enumerated on 2008-06-18 (~18 years ago). That longevity supports the plausibility of sustained high volumes for recurring office visits, biopsies, lesion destruction, and staged Mohs procedures reflected in the claims.

Service mix risk and operational implications: with 39.0% of Medicare revenue concentrated in three codes and many other high‑volume procedure codes present, the provider’s revenue stream is concentrated in frequent office visits, lesion biopsies/destructions, and simulation/guidance services. Any changes in reimbursement or utilization patterns for 99213, 77280, or G6001 could disproportionately affect overall Medicare revenue given their outsized contributions.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

42 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	2,930	$70	$196.6K
77280	The provider uses a simulator or other imaging modality to determine the size and location of ports to be used for radiation therapy. This code describes a simple level service.	790	$220	$173.9K
G6001	Ultrasonic guidance for placement of radiation therapy fields	820	$150	$121.5K
17311	Mohs surgery is a multi–staged procedure that is performed to excise a malignant lesion layer by layer, along with histo–pathological assessment. The assessment is performed to ensure that the…	190	$520	$99.5K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	1,180	$80	$94.7K
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…	990	$90	$92.1K
11102	The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette.	1,330	$60	$83.5K
17000	The provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of the first or only lesion.	1,990	$30	$67.7K
17312	Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins.	120	$340	$40.1K
17004	The provider destroys 15 or more premalignant lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others.	280	$130	$36.9K

Showing 1–10 of 42

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 42 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Delaware Distribution

Kathryn O'reilly — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. state median

42 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
17311	6	10	300	$470	$164.4K
G6001	1	10	690	$150	$102.1K
17312	6	10	140	$330	$55.2K
17313	7	10	80	$480	$51.3K
77427	12	20	290	$150	$39.5K
99214	117	1,830	150	$80	$25.5K
77280	1	10	50	$160	$24.2K
77401	1	10	620	$30	$21K
15260	10	10	20	$690	$19.3K
13121	16	20	50	$240	$19.2K

Showing 1–10 of 42

Related Providers

Other providers that share a Tax Identification Number (TIN) with Kathryn O'reilly, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mitchell Stickler	DE	MOHS-Micrographic Surgery Physician	$1.5M	$0

Nearby Providers

Other providers in the same ZIP code as Kathryn O'reilly, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Beebe Medical Center, Inc.	DE	General Acute Care Hospital	$0	$29.2M
Beebe Physician Network Inc.	DE	Internal Medicine Physician	$0	$19.7M
Juliano Senior Care, Inc.	DE	In Home Supportive Care Agency	$0	$5.9M
Sussex Emergency Associates LLC	DE	Emergency Medicine Physician	$0	$4.3M
Lourdes Aponte	DE	Rheumatology Physician	$3.6M	$0
Jose Pando	DE	Rheumatology Physician	$3.2M	$0
Delaware Psychological Services LLC	DE	Mental Health Counselor	$0	$3M
The Pediatric & Adolescent Center	DE	Specialist	$0	$2.9M
Sea Haven Home Care, LLC	DE	In Home Supportive Care Agency	$0	$2.3M
Southern Delaware Imaging Assoc	DE	Diagnostic Radiology Physician	$0	$2.3M

Kathryn O'reilly — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References