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    v1.0.28
    OpenPayerNPI Medicare & MedicaidPhillip Riley
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    Phillip Riley — Billing Profile & Reimbursement Data

    NPI 1043284391 · Johnson City, TN · Podiatrist

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    Phillip Riley is a podiatrist provider located in Johnson City, Tennessee. This profile covers 14 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.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationPhillip Riley
    Address301 Med Tech Pkwy Ste 106
    CityJohnson City
    StateTN
    ZIP37604
    TaxonomyPodiatrist
    NPI EnumeratedFebruary 14, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$93.3K
    Medicaid$0

    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.

    14 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99204The provider sees a new 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 provider…270$120$31.1K
    99214The 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…270$90$25.2K
    99205The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…50$150$8.3K
    11721The provider surgically debrides (debulks or removes) 6 or more abnormal, diseased, or infected nails.200$30$6.4K
    28010In this procedure, the provider performs a percutaneous tenotomy in which he incises or divides a single tendon in a toe through a small incision in the skin to correct a deformity like hammer toe.30$170$5.6K
    11042The 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$3.8K
    11055The provider removes a single benign hyperkeratotic lesion by using surgical instruments like a scalpel or curette.60$50$3.2K
    99215The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…20$130$2.4K
    11056The provider removes 2 to 4 benign hyperkeratotic lesions by using surgical instruments like a scalpel or curette.40$60$2.3K
    11750The provider removes part or all of a fingernail or toenail, including the nail plate and matrix and including the lunula if the excision is complete.20$110$2.1K

    Showing 1–10 of 14

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    14 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992143,07811,370120$80$16.6K
    11721119210240$30$9.4K
    11042193250100$60$9.1K
    992152,0932,71040$110$8.3K
    9921310,23911,03080$50$8K
    110569112090$50$7K
    99204365,49030$100$5.3K
    992052191,30020$140$4.9K
    2801021020$130$4.7K
    117208490110$20$4.3K

    Showing 1–10 of 14

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Phillip Riley, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Medical Education Assistance CorporationTNInternal Medicine Physician$0$31.1M
    State Of Franklin Healthcare Associates PLLCTNInternal Medicine Physician$0$23.2M
    Medical Education Assistance CorporationTNClinical Medical Laboratory$114.7K$2M
    Raymond KohneTNDiagnostic Radiology Physician$984.7K$0
    Andrea HetheringtonTNObstetrics & Gynecology Nurse Practitioner$337.9K$0
    Mark WilliamsTNInternal Medicine Physician$311.7K$0
    Raymon AggarwalTXInternal Medicine Physician$285K$0
    Victor MarlarNCEndocrinology, Diabetes & Metabolism Physician$236.6K$0
    Gerald FalascaTNRheumatology Physician$233.6K$0
    Celso EbeoTNCritical Care Medicine (Internal Medicine) Physician$125.2K$92.5K

    Nearby Providers

    Other providers in the same ZIP code as Phillip Riley, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Cura Partners, LLCTNIn Home Supportive Care Agency$0$49.3M
    Mountain States Health AllianceTNGeneral Acute Care Hospital$0$31.3M
    Tri-cities Regional Emergency Physicians, PCTNEmergency Medicine Physician$0$24.7M
    Catalyst Health Solutions,llcTNSubstance Use Disorder Rehabilitation Clinic/Center$0$18.7M
    Mountain States Health AllianceTNGeneral Acute Care Hospital$0$8.1M
    Juhn And Stark LLCTNPediatric Dentistry$0$8.1M
    First Tennessee Human Resource AgencyTNNon-emergency Medical Transport (VAN)$0$4.7M
    Mountain Empire Radiology Inc PCTNDiagnostic Radiology Physician$0$4.5M
    Tri-city Pediactric Cardiology P CTNPediatric Cardiology Physician$0$4.5M
    Brit E. Bowers, Dds, P. C.TNDental Clinic/Center$0$4.4M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 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.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Tennessee Distribution
    Phillip Riley — 1 of 14 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Tennessee