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NPI 1154307619 · Warwick, RI · Diagnostic Radiology Physician
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Linda Donegan is a diagnostic radiology physician provider located in Warwick, Rhode Island. This profile covers 11 Medicare and 7 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 | Linda Donegan |
| Address | 125 Metro Center Boulevard Suite 2000 |
| City | Warwick |
| State | RI |
| ZIP | 02886 |
| Taxonomy | Diagnostic Radiology Physician |
| NPI Enumerated | December 16, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $329K |
| Medicare | $263.3K |
LINDA DONEGAN’s billing mix is concentrated in breast imaging and image-guided breast biopsy consistent with her Diagnostic Radiology Physician taxonomy: Medicare top codes include 77067 ($123.9K, 47.1% of Medicare revenue), 77063 ($50.4K, 19.2%), and 19083 ($23.9K, 9.1%), while Medicaid volumes are dominated by 77067 ($218K, 66.5%), 77063 ($60.6K, 18.5%), and 76642 ($26.6K, 8.1%). This pattern points to an operation focused on mammography screening/tomosynthesis and targeted breast biopsies rather than broad cross-sectional or vascular radiology services.
Revenue concentration is high on both payers: the top 3 Medicare codes account for 75.4% of Medicare revenue and the top 3 Medicaid codes account for 93.1% of Medicaid revenue. This level of concentration indicates the practice depends heavily on a narrow set of breast imaging and biopsy services for the majority of its third‑party revenue.
On payer mix, Medicaid ($329K) exceeds Medicare ($263.3K) in lifetime revenue, so the provider is not single‑payer and appears to derive slightly more revenue from Medicaid overall. Both payers are meaningful to the business model, with Medicaid representing the larger share of lifetime collections.
Nationally, the provider’s screening mammography volumes are typical while one biopsy code is an outlier: 77067 ranks #1796 of 15198 (88th percentile) and 77063 ranks #1645 of 14277 (88th percentile), both characterized as typical, unremarkable volumes; by contrast 19083 ranks #95 of 3438 (97th percentile) and is labeled notably above typical national volume, indicating a comparatively high ultrasound‑guided breast biopsy activity relative to peers. Taken together this suggests a modestly scaled imaging provider with a specialized biopsy throughput above national norms.
Within Rhode Island Medicaid peers the provider is a strong statewide participant for screening mammography: 77067 ranks #9 of 54 in‑state (85th percentile) and 77063 ranks #10 of 47 (80th percentile), while other Medicaid codes (for example 76642 at #10 of 27, 65th percentile) show more moderate positioning. These rankings imply competitive strength in mammography screening locally, but more typical volumes for ancillary breast imaging services.
The NPI was enumerated on 2005-12-16 (~21 years ago), indicating an established presence in the market. This tenure is consistent with developing referral relationships and steady service-line focus on breast imaging over time.
A notable coding pattern: Medicare lists A9575 with 3K claims but $0 revenue (rank #2394 of 3208, 25th percentile), which is an atypical claim/revenue pairing in the dataset and may reflect pass‑through supply reporting or non-billed supply items rather than direct professional revenue. This data point, together with high biopsy yield on 19083, suggests reviewers should check billing treatment of contrast/supply items and how they are recorded relative to professional imaging claims.
Operationally, the average paid/claim differences reflect the business mix: for Medicare 77067 pays $135/claim while 19083 pays $420/claim, showing biopsies generate substantially higher per‑claim revenue even though screening codes drive most claims and total volume. For Medicaid the profile is similar in volume dominance (77067 2.6K claims) with lower per‑claim payments (77067 $83 avg paid/claim, 77063 $33 avg paid/claim), indicating a high-volume screening workflow with biopsies as higher‑margin but lower‑volume services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 77067 | The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software… | 920 | $140 | $123.9K |
| 77063 | The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis… | 920 | $60 | $50.4K |
| 19083 | Under ultrasound guidance, the provider takes breast tissue percutaneously from a single lesion for biopsy. He may place a localization device at the same time. | 60 | $420 | $23.9K |
| 76641 | In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images. | 150 | $110 | $16.4K |
| 19081 | Under stereotactic guidance, the provider takes breast tissue percutaneously from a single lesion for biopsy. He may place a localization device at the same time. | 30 | $400 | $12.9K |
| 77065 | The provider performs X–ray imaging on one breast in a patient with a known lump or suspected cancer and may use specially designed computer software to help identify or diagnose potential… | 130 | $100 | $12.7K |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | 170 | $40 | $7.5K |
| 77066 | The provider performs X–ray imaging on both breasts in a patient with a lump or suspected cancer and may use specially designed computer software to help identify or diagnose potential abnormalities… | 50 | $130 | $6.1K |
| 77049 | The provider obtains images of both breasts by applying an external magnetic field and radiofrequency waves to create three–dimensional images, with and without contrast; he may also perform… | 20 | $290 | $4.9K |
| 76642 | In this procedure, the provider performs a focused ultrasound of one breast on a limited area. The procedure includes documentation of the images. | 60 | $70 | $4.2K |
Showing 1–10 of 11
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 77067 | The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software… | 2,630 | $80 | $218K |
| 77063 | The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis… | 1,840 | $30 | $60.6K |
| 76642 | In this procedure, the provider performs a focused ultrasound of one breast on a limited area. The procedure includes documentation of the images. | 430 | $60 | $26.6K |
| 77065 | The provider performs X–ray imaging on one breast in a patient with a known lump or suspected cancer and may use specially designed computer software to help identify or diagnose potential… | 110 | $80 | $9K |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 50 | $130 | $6.3K |
| 77066 | The provider performs X–ray imaging on both breasts in a patient with a lump or suspected cancer and may use specially designed computer software to help identify or diagnose potential abnormalities… | 40 | $100 | $4.4K |
| 76641 | In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images. | 30 | $90 | $2.7K |
How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Rhode Island median
7 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 62 | 70 | 360 | $90 | $154.9K |
| 77067 | The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software… | 9 | 50 | 450 | $70 | $152.4K |
| 77066 | The provider performs X–ray imaging on both breasts in a patient with a lump or suspected cancer and may use specially designed computer software to help identify or diagnose potential abnormalities… | 12 | 10 | 270 | $100 | $67.5K |
| 76642 | In this procedure, the provider performs a focused ultrasound of one breast on a limited area. The procedure includes documentation of the images. | 10 | 30 | 220 | $60 | $59K |
| 77063 | The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis… | 10 | 50 | 430 | $30 | $47K |
| 77065 | The provider performs X–ray imaging on one breast in a patient with a known lump or suspected cancer and may use specially designed computer software to help identify or diagnose potential… | 8 | 10 | 190 | $80 | $42.5K |
| 76641 | In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images. | 4 | 10 | 40 | $130 | $11.9K |
Other providers in the same ZIP code as Linda Donegan, ranked by combined Medicare and Medicaid revenue.
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