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

Why is the Medicaid comparison limited to New York 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. New York (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.

Brian Fallon (NPI 1528220068)

Field	Value
Entity Type	Individual
Organization	Brian Fallon
Address	301 E Main St
City	Bay Shore
State	NY
ZIP	11706
Taxonomy	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
NPI Enumerated	June 26, 2008

Payer Source	Total Paid
Medicare	$42.5K
Medicaid	$0

Medicare: Complete Services Breakdown

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

6 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…	180	$110	$20.1K
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…	70	$150	$10.7K
99443	N/A	50	$110	$5.7K
31624	In this procedure, the provider uses a rigid or flexible bronchoscope for bronchial alveolar lavage, a procedure using saline solution to wash the cells from alveoli, the air sacs at the end of the…	50	$70	$3.1K
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	$160	$2.1K
31625	The provider uses a rigid or flexible bronchoscope to obtain one or more bronchial or endobronchial biopsies to diagnose lung disease. The provider may use fluoroscopic guidance.	10	$70	$870

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New York Distribution

Brian Fallon — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New York

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	9,730	30,450	90	$100	$19K
99223	7,842	8,650	40	$150	$9.3K
99204	2,903	14,170	30	$130	$6.6K
99443	337	1,200	30	$90	$5.7K
31624	19	90	20	$40	$1.4K
31625	6	10	10	$70	$1.2K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Shore University Hospital	NY	General Acute Care Hospital	$0	$47.3M
Anthony Rizzo	NY	Family Medicine Physician	$1.3M	$153.9K
Gerry Rubin	NY	Hematology & Oncology Physician	$730.9K	$113.5K
Michael Nett	NY	Orthopaedic Surgery Physician	$718.3K	$3.7K
Louis Guida	NY	Specialist	$315.1K	$334.6K
Keith Reinhardt	NY	Orthopaedic Surgery Physician	$639.2K	$540
Amit Sharma	NY	Interventional Pain Medicine Physician	$618K	$590
Robert Chow	NY	Infectious Disease Physician	$560.9K	$0
Laura Lennon	NY	Cardiovascular Disease Physician	$502.9K	$34.3K
John Muratori	NY	Family Medicine Physician	$495.2K	$10.4K

Brian Fallon — Billing Profile & Reimbursement Data

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Brian Fallon — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References