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NPI 1831514025 · Lima, OH · Dermatology Physician
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Bryan Gray is a dermatology physician provider located in Lima, Ohio. This profile covers 51 Medicare and 12 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 | Bryan Gray |
| Address | 750 W High St Ste 300 |
| City | Lima |
| State | OH |
| ZIP | 45801 |
| Taxonomy | Dermatology Physician |
| NPI Enumerated | February 24, 2014 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.4M |
| Medicaid | $499.2K |
BRYAN GRAY’s Medicare activity is heavily concentrated in a small number of high-revenue items: the top 3 Medicare codes (J3245, Q4234, Q4180) account for 79.0% of the provider’s total Medicare revenue. The largest single Medicare revenue driver is J3245 (injection, tildrakizumab) which alone represents 41.4% of Medicare revenue and suggests substantial use of biologic injection therapy within the practice. Q4234 (Xcellerate) and Q4180 (Revita) together add meaningful procedural/add-on revenue, indicating the practice also bills for device- or product-based dermatologic therapies.
On Medicaid, revenue is also concentrated: the top 3 Medicaid codes account for 68.6% of Medicaid revenue, led by 99214 which contributes 35.3% of the provider’s Medicaid revenue. The Medicaid mix shows a heavy reliance on E/M visits (99214, 99204, 99213, 99203 make up the largest Medicaid items), indicating that under Medicaid this provider’s care is driven predominantly by office-based evaluation and management services rather than high-cost drugs.
Scale and payer mix are skewed toward Medicare in absolute dollars: lifetime Medicare revenue is $2.4M versus Medicaid revenue of $499.2K, so Medicare represents the dominant share of reported public-payer revenue for this provider. This difference implies the provider’s Medicare business, especially biologic injections and add-on procedural codes, is the primary revenue engine while Medicaid operations are more E/M-centric.
Competitive standing on select Medicare codes varies. For J3245 the provider ranks #22 of 225 nationally and sits in the 91st percentile, which indicates relatively high national volume for that biologic compared with peers; by contrast the provider’s high-volume E/M code 99213 ranks in the 99th percentile nationally and is labeled an "extreme outlier," meaning the practice sees far more established-visit volume than typical national dermatology peers. Several procedural and Mohs-related codes (e.g., 17110, 17311, 17312) are in high percentiles (notably 17110 at the 98th percentile), indicating above-typical procedural throughput for lesion destruction and surgical activity.
Within-state Medicaid standing is mixed but shows pockets of above-typical activity for office visits and lesion destruction. For Medicaid 99214 ranks in the 76th percentile in-state (typical volume), while 17110 ranks at the 77th percentile in-state and 17110’s Medicaid revenue share (13.5%) makes destructive lesion procedures a meaningful part of the Medicaid practice. However many Medicaid pathology and injection supply codes rank in lower percentiles, indicating the provider is not a dominant statewide pathology or injectable-supply outlier.
The code mix implies a hybrid dermatology practice model: high-value biologic injections and add-on product/device billing drive Medicare revenue (J3245, Q4234, Q4180), while office E/M visits and lesion destruction procedures drive Medicaid revenue. This pattern suggests the practice treats a mix of chronic inflammatory skin conditions managed with biologics for Medicare patients and provides routine dermatologic visits and lesion treatments for Medicaid patients.
Tenure is long-lived in the Medicare/NPI data: the NPI was enumerated on 2014-02-24 (~12 years ago), indicating this clinician has maintained an active billing presence over a multi-year period. That tenure combined with concentrated revenue streams suggests an established practice with developed service lines rather than a newly entered or transient biller.
Several codes are statistical outliers or notably above typical volume and warrant attention for capacity and service-line planning. The extreme outlier status of 99213 on Medicare (99th percentile) and very high ranks for J3245 (91st percentile) and 17110 (98th percentile) indicate unusually high volumes in both routine office visits and specific procedural/biologic therapy lines compared with peers. These concentrations present opportunities for payers to evaluate utilization patterns, network adequacy, and contract design targeted to high-volume service lines.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
51 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J3245 | Injection, tildrakizumab, 1 mg | 8,600 | $110 | $946K |
| Q4234 | Xcellerate, per square centimeter (add-on, list separately in addition to primary procedure) | 1,080 | $690 | $745.8K |
| Q4180 | Revita, per square centimeter (add-on, list separately in addition to primary procedure) | 250 | $460 | $113.7K |
| 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… | 1,070 | $60 | $64.2K |
| 17110 | The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or… | 680 | $70 | $46.8K |
| 17311 | Mohs surgery is a multi–staged procedure that is performed to excise a malignant lesion layer by layer, along with histo–pathological assessment. The assessment is performed to ensure that the… | 130 | $320 | $42.7K |
| 14041 | The provider replaces the lesions in the forehead, cheeks, chin, mouth, neck, axillae or armpits, genitalia, hands, or feet with the healthy tissues from an adjacent site. This code represents a… | 50 | $690 | $36.1K |
| 17312 | Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins. | 100 | $310 | $31.8K |
| 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… | 340 | $90 | $29.2K |
| 17004 | The provider destroys 15 or more premalignant lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. | 240 | $120 | $28.7K |
Showing 1–10 of 51
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 51 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
51 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| Q4234 | 2 | 10 | 1,080 | $620 | $669.7K |
| J3245 | 1 | 10 | 3,300 | $110 | $431.5K |
| 17311 | 65 | 90 | 260 | $420 | $130.7K |
| Q4180 | 1 | 10 | 250 | $460 | $113.6K |
| 17312 | 51 | 80 | 120 | $290 | $53.3K |
| 88305 | 361 | 560 | 470 | $40 | $39.2K |
| 14021 | 3 | 10 | 20 | $670 | $31.5K |
| 17313 | 29 | 70 | 50 | $410 | $28.2K |
| 14041 | 6 | 20 | 20 | $660 | $23.9K |
| 14061 | 22 | 30 | 20 | $690 | $14.5K |
Showing 1–10 of 51
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.
12 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… | 3,030 | $60 | $175.9K |
| 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… | 1,170 | $80 | $90K |
| 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… | 2,070 | $40 | $76.5K |
| 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… | 1,490 | $50 | $74.6K |
| 17110 | The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or… | 1,330 | $50 | $67.6K |
| 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… | 200 | $40 | $7.2K |
| 99202 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider… | 80 | $40 | $2.7K |
| 11901 | This code describes an intralesional injection of a corticosteroid, such as triamcinolone acetonide, for treatment of large nodules, keloids, lichenified hyperkeratotic lesions, and numerous other… | 50 | $40 | $1.8K |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 460 | $1 | $1.4K |
| 96372 | A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician… | 80 | $10 | $610 |
Showing 1–10 of 12
How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Ohio median
12 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… | 1,072 | 4,510 | 500 | $60 | $377.8K |
| 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… | 1,586 | 5,080 | 560 | $40 | $323.9K |
| 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… | 256 | 340 | 1,220 | $30 | $186.7K |
| 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… | 183 | 1,410 | 120 | $70 | $65.7K |
| 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… | 200 | 1,690 | 120 | $50 | $60.1K |
| 17110 | The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or… | 24 | 100 | 270 | $70 | $54.6K |
| 11901 | This code describes an intralesional injection of a corticosteroid, such as triamcinolone acetonide, for treatment of large nodules, keloids, lichenified hyperkeratotic lesions, and numerous other… | 3 | 10 | 40 | $40 | $20.4K |
| 99202 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider… | 287 | 580 | 80 | $40 | $17.9K |
| 96372 | A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician… | 618 | 840 | 350 | $10 | $13.8K |
| 17000 | The provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of the first or only lesion. | 27 | 40 | 90 | $40 | $12K |
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Other providers in the same ZIP code as Bryan Gray, ranked by combined Medicare and Medicaid revenue.
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