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

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

Stephen Cauley (NPI 1124080080)

Field	Value
Entity Type	Individual
Organization	Stephen Cauley
Address	1014 Northside Dr E
City	Statesboro
State	GA
ZIP	30458
Taxonomy	Optometrist
NPI Enumerated	April 5, 2006

Payer Source	Total Paid
Medicaid	$11.9M
Medicare	$0

Key Findings

Provider profile and payer mix: STEPHEN CAULEY is an Optometrist in STATESBORO, GA with an NPI enumerated 2006-04-05 (~20 years ago). The practice reports no Medicare billing on file and $11.9M in lifetime Medicaid revenue, which makes its current footprint effectively single-payer (Medicaid) in the available claims data.

Revenue concentration: the top three Medicaid codes drive a large share of revenue — V2020 ($3.5M, 29.1%), V2100 ($2.9M, 24.0%), and 92014 ($1.7M, 14.0%) — together accounting for 67.1% of this provider's total Medicaid revenue as precomputed. This concentration indicates a narrow set of services and products account for the majority of billed Medicaid dollars.

Business and service-line implications: the claims mix is dominated by optical dispensing and lens/frame items (V2020 – Frames, V2100 – Sphere single vision) alongside high-volume comprehensive eye examination codes (92014 and 92004). The combination of very high claim counts for frames and single-vision lenses and large volumes of exam codes suggests the operation functions as a high-throughput retail optical practice that pairs in-office eye exams with on-site eyewear dispensing.

Competitive standing in-state: for multiple top codes this provider ranks at the top of Georgia peers and is described as an "extreme outlier, far above typical state volume" — V2020 ranks #1 of 87 providers (100th percentile), V2100 ranks #1 of 80 providers (100th percentile), and 92014 ranks #1 of 66 providers (100th percentile). Those rank positions indicate the provider is a dominant Medicaid supplier in the state for both eyewear products and comprehensive eye exams.

Scale and operational throughput: claim volumes are very large for core items — V2020 157.4K claims, V2100 150.4K claims, 92014 46.4K claims, 92004 32.1K claims, and S0621 29.8K claims — demonstrating sustained high-volume activity across both product dispensing and exam services. These counts are consistent with a practice model that generates revenue through many low-to-moderate-priced items and frequent exam visits rather than a small number of high-dollar procedures.

Payment pattern and mix of unit values: average paid/claim differs across categories — V2020 $22 avg paid/claim, V2100 $19 avg paid/claim, 92014 $36 avg paid/claim, and 92004 $38 avg paid/claim — indicating revenue derives from a mixture of moderate per-claim exam payments plus large volumes of lower per-claim optical goods. Lower-paid lens codes such as V2784 ($5 avg paid/claim) and V2750 ($1 avg paid/claim) further emphasize a volume-driven revenue model.

Non-revenue and administrative codes on file: several billed codes report $0 avg paid/claim (for example V2799, 1036F, G8785, G8428, and S9986) which appear in the claims set but do not contribute recorded Medicaid dollars. These entries reflect claim-level documentation, screening, or administrative status codes present in the data and should be interpreted as reporting items rather than revenue sources.

Tenure and regional market implication: with an NPI on file since 2006-04-05 (~20 years) and top-ranked, extremely high-volume billing for core eyewear and exam codes, this provider represents an established, long-standing Medicaid-facing optical provider in Georgia. Payers and network analysts should treat the practice as a major regional source of Medicaid-dispensed eyewear and routine/comprehensive eye exams when evaluating network capacity and utilization dynamics.

Medicaid: Complete Services Breakdown

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

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
V2020	Frames, purchases	157,390	$20	$3.5M
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	150,380	$20	$2.9M
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…	46,360	$40	$1.7M
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.	32,110	$40	$1.2M
S0621	Routine ophthalmological examination including refraction; established patient	29,770	$40	$1.2M
S0620	Routine ophthalmological examination including refraction; new patient	15,440	$40	$586.8K
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.	76,770	$10	$537.4K
V2784	Lens, polycarbonate or equal, any index, per lens	65,030	$10	$325.2K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	1,890	$30	$58.6K
V2750	Anti-reflective coating, per lens	25,630	$1	$25.6K

Showing 1–10 of 25

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Georgia Distribution

Stephen Cauley — 9 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. Georgia median

25 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…	729	920	370	$60	$360.6K
S0621	Routine ophthalmological examination including refraction; established patient	1	20	110	$40	$86.2K
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	70	240	$40	$68.1K
V2020	Frames, purchases	1	90	650	$20	$68K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	1	80	630	$20	$54.4K
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.	1	70	80	$50	$47.8K
S0620	Routine ophthalmological examination including refraction; new patient	1	20	140	$40	$39.9K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	5	10	80	$20	$30.4K
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,…	19	20	240	$50	$28K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	23	50	370	$20	$21.7K

Showing 1–10 of 25

Related Providers

Other providers that share a Tax Identification Number (TIN) with Stephen Cauley, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kenny Holloway	GA	Optometrist	$0	$163.8K
Virginia Martin	GA	Optometrist	$84.9K	$0
Bonnie Bradley	GA	Optometrist	$48.9K	$0
Tammy Phan	CT	Optometrist	$13.7K	$27.4K
Laura Werner	VT	Optometrist	$38.4K	$0
Frederick Tillman	GA	Optometrist	$30.4K	$0
Brian Kurtz	AL	Optometrist	$23.2K	$0

Nearby Providers

Other providers in the same ZIP code as Stephen Cauley, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pineland Area Community Services Board	GA	Community/Behavioral Health Agency	$0	$38.9M
East Georgia Pediatrics	GA	Specialist	$0	$4M
Cardiovascular Associates Of Eastern Georgia	GA	Specialist	$0	$1.2M
Reliance Treatment Center Of Statesboro	GA	Methadone Clinic	$45.5K	$1.1M
Ogeechee Ob-gyn, LLC	GA	Obstetrics & Gynecology Physician	$0	$779.5K
Statesboro Cardiology, PC	GA	Cardiovascular Disease Physician	$0	$707.4K
James Jackson	GA	Nephrology Physician	$301.4K	$300.4K
Ajay Jain	GA	Cardiovascular Disease Physician	$586.7K	$0
Bulloch County Emergency Medical Service	GA	Land Ambulance	$575.3K	$0
Air Evac Ems Inc	GA	Air Ambulance	$470.9K	$0

Stephen Cauley — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References