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

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

Vision Express, Usa, Inc (NPI 1053558262)

Field	Value
Entity Type	Organization
Organization	Vision Express, Usa, Inc
Address	1088 W. Marine Corp Drive
City	Dededo
State	GU
ZIP	96929
Taxonomy	Optometrist
NPI Enumerated	January 9, 2009

Payer Source	Total Paid
Medicaid	$72.8K
Medicare	$0

Key Findings

VISION EXPRESS, USA, INC is an optometrist practice registered in DEDEDO, GU with an NPI enumerated on 2009-01-09 (~17 years ago), indicating long-standing presence in the local market. The taxonomy and tenure are consistent with a steady, single-location optometry operation rather than a recently established entrant.

This provider has no Medicare billing on file (Total Medicare revenue: none) and instead reports Medicaid-only revenue totaling $72.8K, making its payer mix effectively single-payer at present. Analysts should treat Medicare exposure as nil for lifetime billing and focus competitive and utilization analysis on Medicaid activity.

Revenue concentration in Medicaid is extremely high: the precomputed top 3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue, reflecting a very narrow set of billable services driving all reported Medicaid dollars. This level of concentration suggests the practice’s Medicaid business is almost entirely tied to a small set of optometry service lines.

The largest single revenue driver is V2199 (Not otherwise classified, single vision lens): 443 claims, $124 avg paid/claim, $54.9K revenue, which represents 75.4% of this provider's Medicaid revenue. The other material code is 92015 (vision determination/refraction): 895 claims, $20 avg paid/claim, $17.9K revenue, representing 24.6% of Medicaid revenue; together these codes explain the entirety of reported Medicaid payments.

Operationally, the mix — a majority of revenue from V2199 and the balance from 92015 — indicates a business model weighted toward dispensing corrective lenses with accompanying vision determination services. The combination of a higher avg paid/claim for V2199 and a larger claim volume for 92015 suggests the practice pairs lower-priced, higher-frequency clinical services with higher-unit-value device dispensing.

Competitive standing in-state is modest: V2199 ranks #3 of 4 providers in-state (33th percentile; typical, unremarkable volume for this code) and 92015 ranks #3 of 5 providers (50th percentile; typical, unremarkable volume for this code). These ranks indicate the provider is a routine participant in state Medicaid markets for these codes, not a dominant or outlier performer.

The provider’s revenue profile shows that a relatively small claim count for V2199 (443 claims) generates the majority of Medicaid dollars due to its $124 avg paid/claim, whereas 92015 has higher claim volume (895 claims) but a much lower avg paid/claim of $20. This divergence between claim count and revenue per claim is important for payers modeling cost drivers and for any contract negotiations targeting eyewear dispensing versus exam services.

With $72.8K of lifetime Medicaid revenue and a focused two-code revenue mix, this entity appears to be a small, established local optometry retailer whose Medicaid impact is limited in scale. Analysts should therefore treat it as a stable but modest participant when assessing state-level network capacity and cost exposure for vision care services.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
V2199	Not otherwise classified, single vision lens	440	$120	$54.9K
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.	900	$20	$17.9K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Guam Distribution

Vision Express, Usa, Inc — 0 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Guam

Full comparison — all codes billed, vs. Guam median

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
V2199	Not otherwise classified, single vision lens	3	10	480	$120	$63.3K
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.	3	10	900	$20	$15.9K

Nearby Providers

Other providers in the same ZIP code as Vision Express, Usa, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Guam Healthcare Development Incorporated	GU	Clinic/Center	$0	$30.8M
C V Alegria Dds Inc	GU	General Practice Dentistry	$0	$11.3M
Albert Huang	GU	Dentist	$0	$5.4M
Usrc Finegayan, LLC	GU	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.5M
Renal Centers Of Guam, LLC	GU	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.1M
Government Of Guam Department Of Administration	GU	Federally Qualified Health Center (FQHC)	$0	$2.4M
Maria Chela Mariano	GU	Family Medicine Physician	$0	$1.8M
Scott Shay	GU	Vascular & Interventional Radiology Physician	$1.2M	$0
Anthony Bekkerman	GU	Emergency Medicine Physician	$49.5K	$623.9K
Blue Ocean Medical Group LLC	GU	Family Medicine Physician	$0	$665.1K

Vision Express, Usa, Inc — Billing Profile & Reimbursement Data

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Vision Express, Usa, Inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References