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 Connecticut for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Connecticut 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. Connecticut (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.

Miechelle O'brien (NPI 1356582571)

Miechelle O'brien is a gastroenterology physician provider located in Danbury, Connecticut. 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)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Miechelle O'brien
Address	111 Osborne Street- Ste 121
City	Danbury
State	CT
ZIP	06810
Taxonomy	Gastroenterology Physician
NPI Enumerated	March 18, 2009

Payer Source	Total Paid
Medicare	$31.4K
Medicaid	$0

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99215	The 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…	60	$150	$8.1K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	60	$110	$6.9K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	30	$200	$5.3K
99204	The 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…	20	$130	$2.9K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	30	$80	$2.6K
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…	30	$90	$2.1K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	10	$140	$1.6K
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…	20	$70	$1.5K
45381	The provider inserts a flexible endoscope into the anus and navigates the scope through the entire colon. The provider performs one or more injections into the submucosa (the tissue below the mucous…	20	$10	$220

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
45385	188	240	50	$290	$19.3K
99214	5,488	6,480	90	$90	$14.2K
45380	69	240	40	$190	$11.5K
43239	176	240	50	$120	$8.9K
99213	5,493	6,440	70	$60	$8.1K
99223	1,513	1,660	30	$140	$7.3K
99215	500	1,840	30	$130	$6.7K
99204	1,535	2,660	30	$120	$4.6K
45381	3	10	20	$190	$3K

Miechelle O'brien — Billing Profile & Reimbursement Data

Sign up for Miechelle O'brien — Billing Profile & Reimbursement Data policy alerts

Miechelle O'brien — Billing Profile & Reimbursement Data

Sign up for Miechelle O'brien — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References