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.

Novo-vision Ophthalmology Clinic Psc (NPI 1215228077)

Novo-vision Ophthalmology Clinic Psc is a medical specialty clinic/center provider located in Corozal, Puerto Rico. This profile covers 0 Medicare and 22 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	Novo-vision Ophthalmology Clinic Psc
Address	Building Plaza Del Carmen, St 159
City	Corozal
State	PR
ZIP	00783
Taxonomy	Medical Specialty Clinic/Center
NPI Enumerated	April 28, 2011

Payer Source	Total Paid
Medicaid	$2.8M
Medicare	$0

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	18,220	$50	$838K
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…	800	$790	$637.6K
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.	11,500	$30	$298.9K
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.	8,810	$20	$184.9K
92002	The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program.	3,610	$40	$147.9K
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…	6,190	$20	$136.2K
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…	1,200	$110	$134K
92285	Code 92285 describes photography of abnormalities using any of the methods described for documentation purposes and later comparison.	6,840	$10	$75.2K
92226	N/A	6,450	$10	$58.1K
76519	The provider uses A scan ultrasound echography to measure the axial length of the eye and determine the intraocular lens, or IOL calculation prior to cataract surgery.	580	$90	$51.5K

Showing 1–10 of 22

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

Novo-vision Ophthalmology Clinic Psc — 8 of 20 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

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	16	60	160	$380	$270.5K
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	350	540	$50	$96.4K
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…	2	10	210	$90	$87.8K
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…	25	120	180	$80	$62.9K
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.	4	80	650	$20	$43.1K
92002	The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program.	23	440	370	$40	$38.5K
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	530	630	$20	$32K
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.	70	200	120	$80	$30.5K
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,…	16	160	420	$20	$26.4K
76519	The provider uses A scan ultrasound echography to measure the axial length of the eye and determine the intraocular lens, or IOL calculation prior to cataract surgery.	4	20	170	$70	$22.8K

Showing 1–10 of 22

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratorio Clinico Tiago Inc.	PR	Clinical Medical Laboratory	$1.2K	$2.3M
Salud Integral En La Montana, Inc	PR	Clinical Medical Laboratory	$100	$2.1M
Jose Arias Benabe	PR	Physical Medicine & Rehabilitation Physician	$11.9K	$1.4M
Centro Radiologico Sonografico Digital De Corozal	PR	Radiology Clinic/Center	$0	$1.1M
Adalberto Molina	PR	Optometrist	$0	$957.5K
Yousef Cruz-inigo	PR	Retina Specialist (Ophthalmology) Physician	$5.3K	$892.9K
Laboratorio Clinico Cibuco Inc	PR	Clinical Medical Laboratory	$0	$873K
Laboratorio Clinico Corozal, Inc.	PR	Clinical Medical Laboratory	$3K	$773.2K
Laboratorio Clinico Corozal Inc	PR	Clinical Medical Laboratory	$1.3K	$689.7K
Walgreen Co	PR	Pharmacy	$62.3K	$0

Novo-vision Ophthalmology Clinic Psc — Billing Profile & Reimbursement Data

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Novo-vision Ophthalmology Clinic Psc — 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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