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NPI 1295720845 · O Fallon, IL · Sports Medicine (Family Medicine) Physician
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Richard Derby is a sports medicine (family medicine) physician provider located in O Fallon, Illinois. This profile covers 10 Medicare and 5 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 | Richard Derby |
| Address | 670 Pierce Blvd |
| City | O Fallon |
| State | IL |
| ZIP | 62269 |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| NPI Enumerated | September 20, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $121.5K |
| Medicaid | $55.2K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
10 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 20611 | In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa, typically the shoulder, hip, knee, or subacromial bursa, and then uses the syringe… | 400 | $90 | $34.8K |
| 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… | 380 | $70 | $26.1K |
| J7318 | Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg | 5,210 | $10 | $26K |
| J7325 | Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg | 1,820 | $10 | $12.8K |
| 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… | 110 | $90 | $10.6K |
| 99203 | The provider sees a new 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 provider… | 80 | $80 | $6.1K |
| 73562 | In this procedure, the provider takes three X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area. | 80 | $20 | $1.3K |
| 73030 | This particular procedure is for a minimum of 2 X–ray views of the complete shoulder. | 80 | $20 | $1.3K |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 1,060 | $1 | $1.1K |
| 73502 | In this diagnostic procedure, the provider takes X–ray images of one hip, either left or right, from two or three projections (directions or angles) to check for any fracture, swelling, or other… | 20 | $20 | $500 |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 10 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
10 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 99214 | 9,210 | 18,540 | 110 | $80 | $17.1K |
| J7325 | 27 | 60 | 1,700 | $10 | $16.4K |
| J7318 | 9 | 60 | 1,620 | $10 | $14.4K |
| 20611 | 29 | 390 | 80 | $80 | $12.2K |
| 99213 | 1,480 | 17,390 | 70 | $60 | $8.8K |
| 99203 | 1,223 | 6,150 | 30 | $70 | $3.8K |
| 73562 | 326 | 1,110 | 50 | $20 | $1.6K |
| 73502 | 1,119 | 1,390 | 50 | $20 | $1.5K |
| 73030 | 382 | 1,420 | 50 | $20 | $1.2K |
| J3301 | 176 | 1,460 | 180 | $1 | $400 |
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.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 440 | $60 | $26.5K |
| 20611 | In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa, typically the shoulder, hip, knee, or subacromial bursa, and then uses the syringe… | 400 | $30 | $13.7K |
| 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… | 230 | $40 | $8.6K |
| 99203 | The provider sees a new 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 provider… | 160 | $30 | $5.5K |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 160 | $10 | $950 |
How this provider's Medicaid billing volume and revenue compare to other Illinois providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Illinois median
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 6,220 | 14,680 | 300 | $50 | $48.7K |
| 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… | 7,636 | 14,190 | 280 | $20 | $38.9K |
| 20611 | In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa, typically the shoulder, hip, knee, or subacromial bursa, and then uses the syringe… | 22 | 60 | 100 | $20 | $12.2K |
| 99203 | The provider sees a new 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 provider… | 1,082 | 3,270 | 80 | $40 | $11.1K |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 99 | 280 | 80 | $10 | $1.7K |
Other providers in the same ZIP code as Richard Derby, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Southern Illinois Healthcare Foundation Inc | IL | Federally Qualified Health Center (FQHC) | $0 | $7.9M |
| Ssm Cardinal Glennon Childrens Hospital | IL | Pediatrics Physician | $0 | $5.4M |
| John Visconti | IL | Medical Oncology Physician | $2.8M | $149.1K |
| Brett Herzog | IL | Medical Oncology Physician | $1.9M | $40.7K |
| Mark Walshauser | IL | Hematology & Oncology Physician | $437.5K | $395.5K |
| O'fallon Surgical Center, LLC | IL | Ambulatory Surgical Clinic/Center | $793.7K | $0 |
| Scott Roustio | IL | Emergency Medicine Physician | $83.8K | $625.5K |
| Michael Stock | IL | Ophthalmology Physician | $669.2K | $0 |
| Raghav Govindarajan | IL | Neuromuscular Medicine (Psychiatry & Neurology) Physician | $377.7K | $282.1K |
| Patrick Win | IL | Allergy & Immunology Physician | $597.5K | $0 |
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