Physician
O'brien, James
O'brien, James was paid $160K by Medicaid between Jan 2018 and Nov 2020, across 21 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 46% of everything it billed.
33Billing provider infoO'BRIEN, JAMES
PROVIDENCE, RI 02905
PROVIDENCE, RI 02905
33aNPI1043230030assigned 07/20/2006
33bProvider typeObstetrics & Gynecology Physician
28Total paid$160K
24GClaims2,114
24DCodes billed21
24AFirst – last monthJan 2018 – Nov 2020
Compared with peers
Next to other Obstetrics & Gynecology Physician providers in Rhode Island
Rank by total paid#20 of 106
Median peer was paid$8K
This provider vs. median19×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 1,037 | $89K | |
| 2019 | 699 | $50K | |
| 2020 | 378 | $22K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 46% | 909 | 772 | $73K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 17% | 193 | 181 | $27K |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 14% | 193 | 181 | $23K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 5.3% | 58 | 54 | $9K |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | 4.1% | 100 | 100 | $7K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 3.6% | 140 | 137 | $6K |
| 86780 | 2.5% | 90 | 90 | $4K | |
| 86803 | 1.4% | 24 | 24 | $2K | |
| 87340 | 1.2% | 25 | 25 | $2K | |
| 76801 | 1.1% | 13 | 13 | $2K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 26 | 24 | $1K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 30 | 29 | $744.03 |
9 more codes
| 81025 | <1% | 19 | $727.28 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 27 | $692.63 |
| 86850 | <1% | 12 | $643.99 | |
| 86900 | <1% | 12 | $609.51 | |
| 86901 | <1% | 12 | $609.51 | |
| 87210 | <1% | 29 | $514.64 | |
| 83986 | <1% | 13 | $276.15 | |
| 3078F | <1% | 115 | $0.40 | |
| 3074F | <1% | 74 | $0.07 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.