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

Why is the Medicaid comparison limited to Puerto Rico 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. Puerto Rico (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.

Instituto De Ojos Y Piel, Inc (NPI 1073557252)

Instituto De Ojos Y Piel, Inc is a optometrist provider located in Carolina, Puerto Rico. This profile covers 0 Medicare and 27 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	Instituto De Ojos Y Piel, Inc
Address	Road 3 Km12.5
City	Carolina
State	PR
ZIP	00985
Taxonomy	Optometrist
NPI Enumerated	June 16, 2006

Payer Source	Total Paid
Medicaid	$3.2M
Medicare	$0

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

27 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…	1,420	$550	$775.4K
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…	18,430	$30	$516K
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…	10,580	$40	$412.6K
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…	4,130	$70	$301.4K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	2,670	$110	$290.5K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	11,100	$20	$210.9K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	8,870	$20	$195.2K
V2632	Posterior chamber intraocular lens	620	$200	$121.3K
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.	6,550	$20	$104.7K
92202	The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece…	7,110	$10	$71.1K

Showing 1–10 of 27

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Puerto Rico Distribution

Instituto De Ojos Y Piel, Inc — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Puerto Rico

Full comparison — all codes billed, vs. Puerto Rico median

27 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9035	Injection, bevacizumab, 10 mg	8	20	370	$2,820	$2.3M
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…	9	60	160	$380	$270.5K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	7	30	1,090	$130	$222.2K
67228	In retinopathy, tiny new vessels grow profusely and fibrous tissue proliferates in between the layers of the retina, which may extend into the optic nerve and vitreous, clear gel that fills the space…	11	10	110	$510	$153.3K
V2632	Posterior chamber intraocular lens	1	10	620	$200	$121.6K
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…	3	350	540	$50	$96.4K
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…	2	120	180	$80	$62.9K
C9257	Injection, bevacizumab, 0.25 mg	13	20	350	$50	$61.8K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	3	80	650	$20	$43.1K
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.	22	530	630	$20	$32K

Showing 1–10 of 27

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Instituto De Ojos Y Piel, Inc	PR	Ambulatory Surgical Clinic/Center	$15.9K	$577.7K
Maria Velazquez Lamela	PR	Glaucoma Specialist (Ophthalmology) Physician	$17.2K	$152.8K
Oscar Hernandez	PR	Ophthalmology Physician	$23.3K	$8.8K
Jose Quintero	PR	Cornea and External Diseases Specialist Physician	$24.1K	$590
Miguel Santiago-garcia	PR	Ophthalmology Physician	$16.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Clinical Medical Services Inc	PR	Durable Medical Equipment & Medical Supplies	$0	$2.4M
Health Laboratories Services Inc	PR	Clinical Medical Laboratory	$28.3K	$2.3M
Ada Colon-gavillan	PR	Physical Therapy Clinic/Center	$0	$1.4M
Pedro Rivera Caballero	PR	General Practice Physician	$3.1K	$1.3M
Rivera-revilla Lab LLC	PR	Clinical Medical Laboratory	$4K	$1.3M
Centro Radiodiagnostico Carolina	PR	Diagnostic Radiology Physician	$0	$1.2M
Family Medicine Group Inc.	PR	Adult Medicine Physician	$0	$1.1M
Juan Ledoux	PR	General Practice Dentistry	$0	$968K
Milab LLC	PR	Clinical Medical Laboratory	$1.9K	$889.3K
Inspira Behavioral Care Corp.	PR	Adult Mental Health Clinic/Center	$0	$789.3K

Instituto De Ojos Y Piel, Inc — Billing Profile & Reimbursement Data

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Instituto De Ojos Y Piel, Inc — 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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