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

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

Boes Eye Care (NPI 1003180217)

Boes Eye Care is a ophthalmology physician provider located in Great Falls, Montana. This profile covers 0 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.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Boes Eye Care
Address	2800 11th Ave S
City	Great Falls
State	MT
ZIP	59405
Taxonomy	Ophthalmology Physician
NPI Enumerated	March 6, 2012

Payer Source	Total Paid
Medicaid	$786.2K
Medicare	$0

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
66984	The 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…	1,240	$310	$383.2K
92014	An 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…	1,530	$70	$110.3K
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…	560	$110	$63.3K
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…	1,150	$50	$62.2K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	580	$100	$57K
92136	The 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…	1,780	$30	$53.4K
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	620	$50	$29K
92083	The 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…	210	$40	$7.9K
99072	The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items…	380	$20	$6.8K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	30	$240	$6.5K

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Montana Distribution

Boes Eye Care — 2 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	216	520	730	$40	$196.4K
92014	An 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…	43	130	600	$90	$120.9K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	54	120	440	$110	$96K
66984	The 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…	1	10	210	$270	$90.8K
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…	21	130	100	$120	$49.4K
92136	The 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…	1	10	50	$30	$18.1K
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	9	30	270	$10	$12.6K
99072	The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items…	19	30	560	$10	$10.8K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	145	240	170	$1	$10.3K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	1	10	30	$240	$6.5K

Showing 1–10 of 12

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Boes	MT	Ophthalmology Physician	$1.1M	$50
Fred Abraham	MT	Optometrist	$295K	$950

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Benefis Hospitals Inc	MT	Multi-Specialty Clinic/Center	$0	$38.2M
Great Falls Public Schools	MT	Local Education Agency (LEA)	$0	$15M
Great Falls Pediatric Dentistry, LLC	MT	Pediatric Dentistry	$0	$14.9M
Benefis Community Care, Inc.	MT	Case Management Agency	$0	$13.2M
Great Falls Clinic LLC	MT	Multi-Specialty Clinic/Center	$0	$11.2M
Easterseals-goodwill Northern Rocky Mountain, Inc.	MT	Developmentally Disabled Services Day Training Agency	$0	$7.4M
Levi C Maltby Dmd P.C.	MT	Dentist	$0	$6M
Great Falls Emergency Services Inc	MT	Land Ambulance	$842.6K	$4.4M
Benefis Hospitals, Inc.	MT	Air Ambulance	$0	$5.2M
Easterseals Goodwill N. Rocky Mtn	MT	Developmentally Disabled Services Day Training Agency	$0	$3.7M

Boes Eye Care — Billing Profile & Reimbursement Data

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Boes Eye Care — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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