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

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

Children's Eye Physicians P.C. (NPI 1114962651)

Children's Eye Physicians P.C. is a ophthalmology physician provider located in Wheat Ridge, Colorado. 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	Children's Eye Physicians P.C.
Address	4875 Ward Rd
City	Wheat Ridge
State	CO
ZIP	80033
Taxonomy	Ophthalmology Physician
NPI Enumerated	June 18, 2006

Payer Source	Total Paid
Medicaid	$3.8M
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
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…	23,910	$100	$2.3M
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.	6,350	$110	$717K
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…	2,280	$130	$294.5K
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…	4,110	$70	$279.1K
92060	The basic eye sensorimotor exam checks the alignment of the eyes and their ability to move together in eight fields of gaze ( up, down, right, left, up–left, up–right, down–left, down–right) and…	2,570	$50	$125.8K
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.	34,540	$1	$69.1K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	340	$60	$20.9K
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…	250	$50	$13.4K
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…	50	$50	$2.2K
92310	The provider performs all components of contact lens prescription and fitting for both eyes except when there is absence of the lens of the eye (aphakia) as a result of prior cataract surgery.	20	$80	$1.2K

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Children's Eye Physicians P.C. — 4 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado 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…	2,007	2,520	330	$100	$352K
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…	1,541	2,630	430	$90	$268.2K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	111	220	340	$60	$188.2K
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…	6	410	370	$90	$187.5K
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.	20	450	250	$100	$120.7K
92060	The basic eye sensorimotor exam checks the alignment of the eyes and their ability to move together in eight fields of gaze ( up, down, right, left, up–left, up–right, down–left, down–right) and…	5	30	510	$50	$65.2K
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…	45	990	90	$120	$57.9K
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…	6	100	190	$60	$47.5K
92310	The provider performs all components of contact lens prescription and fitting for both eyes except when there is absence of the lens of the eye (aphakia) as a result of prior cataract surgery.	17	20	80	$100	$42.3K
92133	The provider performs computerized diagnostic imaging of the optic nerve in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both…	27	30	110	$20	$10.8K

Showing 1–10 of 12

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Christopher Bardorf	CO	Pediatric Ophthalmology and Strabismus Specialist Physician Physician	$27.3K	$0
Adrienne Ruth	CO	Pediatric Ophthalmology and Strabismus Specialist Physician Physician	$11.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Real Care, Inc.	CO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$59.7M
Jefferson Center For Mental Health	CO	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$36.1M
Metro Community Provider Network Inc	CO	Federally Qualified Health Center (FQHC)	$0	$23.6M
Peak Pediatrics PLLC	CO	Clinic/Center	$0	$11.4M
Emergency Service Physicians, Inc.	CO	Emergency Medicine Physician	$0	$11.3M
A Brighter Community LLC	CO	Developmentally Disabled Services Day Training Agency	$0	$10M
Lighthouse Residenital	CO	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$8.9M
My Second Home	CO	Child Intellectual and/or Developmental Disabilities Respite Care	$0	$8M
Children's Eye Physicians PC	CO	Eyewear Supplier	$0	$6M
Metro Community Provider Network Inc	CO	Federally Qualified Health Center (FQHC)	$0	$5.7M

Children's Eye Physicians P.C. — Billing Profile & Reimbursement Data

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Children's Eye Physicians P.C. — 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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