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    v1.0.28
    OpenPayerNPI Medicare & MedicaidCharles Breen
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    Charles Breen — Billing Profile & Reimbursement Data

    NPI 1437151719 · Florence, KY · Ophthalmology Physician

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    Charles Breen is a ophthalmology physician provider located in Florence, Kentucky. This profile covers 14 Medicare and 2 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)

    FieldValue
    Entity TypeIndividual
    OrganizationCharles Breen
    Address7370 Turfway Rd
    CityFlorence
    StateKY
    ZIP41042
    TaxonomyOphthalmology Physician
    NPI EnumeratedJune 1, 2005

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

    Payer SourceTotal Paid
    Medicare$272.3K
    Medicaid$3.4K

    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
    J0178Injection, aflibercept, 1 mg120$690$81.4K
    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…800$80$65.4K
    66984The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…160$390$63.2K
    66821The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.80$240$19.8K
    92004The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.130$90$11.6K
    92134The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.220$30$5.8K
    92136The provider uses a noninvasive method to measure the patient’s eye or eyes to get information that the provider then uses to calculate the appropriate power for an intraocular lens (IOL). Selecting…210$30$5.5K
    92083The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended…130$40$4.9K
    67028The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.60$80$4.5K
    99213The 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…70$60$4.2K

    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
    J01783540870$690$858.5K
    670284450650$90$72.9K
    669842553101,560$40$67.1K
    668215316050$110$16.1K
    992141947,230110$70$14.1K
    9201437142090$80$14K
    992133,8887,25080$50$7.7K
    921346941050$30$6.3K
    9213650120170$30$5.4K
    992042,4463,20030$100$4.8K

    Showing 1–10 of 14

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    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

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    2 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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…60$40$2K
    92014An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…30$50$1.4K

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Kentucky providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Kentucky median

    2 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    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…2,0482,460580$40$245K
    92014An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…666710790$60$98.4K

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Summit Medical Group, IncKYFamily Medicine Physician$0$95.1M
    Summit Medical Group, Inc.KYUrgent Care Clinic/Center$0$4.7M
    Summit Medical Group, IncKYMental Health Clinic/Center (Including Community Mental Health Center)$0$4.2M
    Angelia ThompsonKYOphthalmology Physician$1.8M$381.3K
    John GoochFLOphthalmology Physician$727.5K$0
    John LoudermilkFLFamily Medicine Physician$409.9K$0
    Saad AshrafGAPulmonary Disease Physician$380.7K$0
    Eli CiancioloOHPain Medicine (Anesthesiology) Physician$338.7K$0
    Shoaib AhmadOKPulmonary Disease Physician$276.1K$0
    Pawel SzczykutowiczKYInternal Medicine Physician$268K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Personal Touch Home Care Of Ky, Inc.KYHome Health Agency$0$127.2M
    St Elizabeth Medical Center, IncKYGeneral Acute Care Hospital$0$65.5M
    Northern Kentucky Consumer Directed Options ProgramKYSupports Brokerage Agency$0$52.8M
    Healthy Adult Day Healthcare, LLCKYAdult Day Care Clinic/Center$0$37.7M
    Dungarvin Kentucky, LLC - FlorenceKYDevelopmentally Disabled Services Day Training Agency$0$35.3M
    Northern Kentucky Consumer Directed Option ProgramKYSupports Brokerage Agency$0$27.5M
    Personal Touch Home Care Of Ky, Inc.KYHome Health Agency$0$13.2M
    Tri-generations, LLCKYIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility$0$11.2M
    Bawac, Inc.KYDevelopmentally Disabled Services Day Training Agency$0$5.5M
    Advanced Technology Of Kentucky Inc.KYOxygen Equipment & Supplies (DME)$0$5.1M

    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. Kentucky Distribution
    Charles Breen — 1 of 14 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Kentucky
    Medicaid Revenue by Year vs. Kentucky Providers
    0 of 3 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Kentucky Distribution
    Charles Breen — 0 of 2 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Kentucky