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.

Leonard E. Vainio & David G. Vainio PC (NPI 1053342006)

Field	Value
Entity Type	Organization
Organization	Leonard E. Vainio & David G. Vainio PC
Address	100 W Park Ave
City	Anaconda
State	MT
ZIP	59711
Taxonomy	Optometrist
NPI Enumerated	July 6, 2006

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	4,470	$100	$433.2K
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…	4,820	$80	$380.8K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	7,690	$20	$184.5K
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	10,270	$10	$133.5K
92341	Code 92341 describes the fitting of eyeglasses of bifocal type, i.e., the lens has two separate areas of focus such as an area which gives best near vision and another area giving best far vision.	310	$30	$8.2K
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…	30	$60	$1.8K

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

Leonard E. Vainio & David G. Vainio PC — 3 of 6 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

6 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…	468	530	580	$70	$224.6K
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…	10	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.	4	120	440	$110	$96K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	3	120	760	$20	$40.9K
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	6	130	1,300	$20	$37K
92341	Code 92341 describes the fitting of eyeglasses of bifocal type, i.e., the lens has two separate areas of focus such as an area which gives best near vision and another area giving best far vision.	5	30	70	$30	$5K

Nearby Providers

Other providers in the same ZIP code as Leonard E. Vainio & David G. Vainio PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aware Inc	MT	Community/Behavioral Health Agency	$0	$140.3M
Anaconda School District	MT	Local Education Agency (LEA)	$0	$1.5M
Community Hospital Of Anaconda	MT	Pediatric Adolescent Medicine Physician	$0	$1.4M
Community Hospital Of Anaconda	MT	Family Medicine Physician	$0	$1.1M
Community Hospital Of Anaconda	MT	Critical Access Hospital	$0	$1.1M
Northwest Ehr Collaborative Inc.	MT	Internal Medicine Physician	$0	$982.6K
Pintler Health & Rehab, LLC	MT	Physical Therapist	$0	$614.4K
Anaconda Oxygen Service	MT	Durable Medical Equipment & Medical Supplies	$0	$542K
Lorena Craig	MT	Professional Counselor	$0	$286.2K
Jill Johnson	MT	Dental Hygienist	$0	$260.5K

Leonard E. Vainio & David G. Vainio PC — Billing Profile & Reimbursement Data

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Leonard E. Vainio & David G. Vainio PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References