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

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

Eyecare Plus Hh, PLLC (NPI 1174500714)

Eyecare Plus Hh, PLLC is a optometrist provider located in Antioch, Tennessee. This profile covers 0 Medicare and 32 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

(source: NPPES NPI Registry)

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Eyecare Plus Hh, PLLC
Address	5323 Mount View Rd
City	Antioch
State	TN
ZIP	37013
Taxonomy	Optometrist
NPI Enumerated	December 26, 2005

Payer Source	Total Paid
Medicaid	$3.5M
Medicare	$0

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

32 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…	4,610	$70	$313.8K
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…	5,560	$50	$294.7K
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.	9,160	$30	$293.2K
92273	The provider performs an electrophysiologic test of retinal function, which may be referred to as conventional, full–field or Ganzfeld (ffERG) or flash/focal (fERG) electroretinography to assess…	3,570	$70	$264.1K
92083	The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended…	6,640	$40	$259K
92285	Code 92285 describes photography of abnormalities using any of the methods described for documentation purposes and later comparison.	11,850	$20	$248.9K
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.	2,310	$90	$207.7K
92275	N/A	2,580	$70	$188.3K
95930	The provider performs visual evoked potential testing that measures the electrical activity of the brain in response to a visual stimulus; however, this test is not used for VEP for glaucoma.…	3,340	$50	$160.2K
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,…	4,190	$40	$151K

Showing 1–10 of 32

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Eyecare Plus Hh, PLLC — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

32 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…	521	3,760	610	$40	$202.3K
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…	1,024	4,050	620	$30	$183.9K
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…	11	40	660	$40	$92.1K
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…	42	710	340	$50	$60K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	76	660	190	$60	$53.3K
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…	617	1,240	120	$60	$53.1K
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.	27	580	160	$70	$41.5K
95930	The provider performs visual evoked potential testing that measures the electrical activity of the brain in response to a visual stimulus; however, this test is not used for VEP for glaucoma.…	2	20	270	$40	$36.5K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	39	520	580	$20	$35.4K
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.	17	780	390	$20	$35.1K

Showing 1–10 of 32

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Metropolitan Government Of Nashville & Davidson County	TN	Ambulance	$3.4M	$32M
Urgent Care Enterprise LLC	TN	Urgent Care Clinic/Center	$0	$11.6M
Mighty Hearts Home Care Inc	TN	In Home Supportive Care Agency	$0	$7.6M
Tennessee Pain Surgery Center, LLC	TN	Ambulatory Surgical Clinic/Center	$669.9K	$4.5M
Pain Management Group, P.C.	TN	Interventional Pain Medicine Physician	$0	$4.2M
Prudent Health Services Inc.	TN	Home Health Agency	$0	$3.2M
Savina Kimbrough	TN	Family Nurse Practitioner	$94.6K	$0
John Welker	TN	Interventional Pain Medicine Physician	$77.3K	$0
John Culclasure	TN	Pain Medicine (Anesthesiology) Physician	$24.2K	$0

Eyecare Plus Hh, PLLC — Billing Profile & Reimbursement Data

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Eyecare Plus Hh, PLLC — 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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