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

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

Simon Eye Associates PA (NPI 1205871506)

Field	Value
Entity Type	Organization
Organization	Simon Eye Associates PA
Address	5301 Limestone Rd Ste 128
City	Wilmington
State	DE
ZIP	19808
Taxonomy	Optometrist
NPI Enumerated	June 19, 2006

Payer Source	Total Paid
Medicaid	$665.2K
Medicare	$0

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	6,100	$50	$329.3K
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…	6,240	$40	$255.8K
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.	5,130	$10	$41K
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…	1,100	$40	$38.5K
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.	10	$40	$530
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…	10	$1	$50

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

Simon Eye Associates PA — 1 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

6 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…	272	540	1,100	$40	$185.3K
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	40	330	$50	$172.4K
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.	2	30	150	$70	$55.7K
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.	5	40	460	$10	$22.4K
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…	17	20	360	$20	$14.5K
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.	4	10	50	$40	$5.4K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Simon Eye Associates PA, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laurie Conti	DE	Optometrist	$203.8K	$44.9K
Philip Gross	DE	Optometrist	$101.1K	$0
Bethany Lewallen	DE	Optometrist	$99.1K	$0
Arkady Yatskevich	DE	Optometrist	$92.3K	$0
Adriane Hohmann	DE	Optometrist	$37.7K	$0
Christopher Brennan	PA	Optometrist	$35.1K	$0
Sarah Langan	NE	Optometrist	$24.8K	$0

Nearby Providers

Other providers in the same ZIP code as Simon Eye Associates PA, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
State Of Delaware	DE	Local Education Agency (LEA)	$0	$9.2M
Jp Nacchia & Associates, Inc.	DE	In Home Supportive Care Agency	$0	$8.2M
Macklyn Home Care	DE	Home Health Agency	$0	$6.2M
Journeys LLC	DE	Mental Health Counselor	$0	$5M
Resouces For Human Development, Inc.	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$4.3M
Robert M Collins Dds PA	DE	Pediatric Dentistry	$0	$3.2M
Regional Orthopaedic Associates PA	DE	Orthopaedic Surgery Physician	$0	$2.8M
Rockland Surgery Center, L.P.	DE	Anesthesiology Physician	$2.4M	$280K
Limestone Medical Center, LLC	DE	Ambulatory Surgical Clinic/Center	$2.3M	$242.7K
Pace, Inc.	DE	Adult Mental Health Clinic/Center	$0	$2.3M

Simon Eye Associates PA — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References